What is the clinical evidence from this study?

Study design: Cohort. Population: Free flap vascular compromise (n=113). Intervention: Pre-incision delays. Primary outcome: Salvage versus failure (total loss) (p=0.89).

What does this research mean for the field?

Pre-incision delays, including arrival latency and operating room preparation, are not associated with free-flap salvage failure during re-exploration surgeries. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine whether pre-incision delays between surgery registration and incision correlate with free flap salvage failure and identify workflow targets for clinical improvement.

September 14, 2026MicrosurgeryOpen Access

Pre‐Incision Time Intervals and Outcomes of Free Flap re‐Exploration: A Retrospective Single‐Center Study

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Key result

Pre-incision delays show no association with free-flap salvage failure.

P=0.89
n=113

Why the study?

Are pre-incision delays associated with free-flap salvage failure in patients undergoing free-flap revision surgery?

Population

113 free-flap revision surgeries performed over the past 6 years at a single center

Design

Cohort

Authors

AFAlexander Fiedler NINesrin Ibrahim MFMaria Fueth

Discussion

Member takes

Overview

Pre-incision delays may be associated with free-flap salvage failure; supports workflow targets but leaves open prospective validation.

Key Points

To determine whether pre-incision delays between surgery registration and incision correlate with free flap salvage failure and identify workflow targets for clinical improvement.
Retrospective single-center review of 113 free-flap revision surgeries conducted over 6 years.
Partitioned the registration-to-incision pathway into arrival latency, anesthesia lead time, operating room preparation, and surgery lead time to evaluate primary outcomes of salvage versus total flap loss.
Total flap loss occurred in 14.2% of re-explorations, with no significant difference in median registration-to-incision time between flap salvage and failure (78 min vs. 77 min, p = 0.89).
No significant differences occurred across transit and preparation sub-intervals, including arrival latency (19 min vs. 20 min, p = 0.89), operating room preparation (25 min vs. 22 min, p = 0.66), and door-to-incision duration (52 min vs. 53 min, p = 0.50).
Failures trended toward longer anesthesia lead times (38 vs. 28 min, p = 0.48), longer operative durations (109 vs. 83 min, p = 0.12), and weekend procedures (25% vs. 12%, p = 0.06).

Study Design

Type

Cohort (n=113)

Multicenter

Structured PICO

Are pre-incision delays associated with free-flap salvage failure in patients undergoing free-flap revision surgery?

Population

113 free-flap revision surgeries performed over 6 years to evaluate pre-incision time intervals and outcomes.

Exposure

Pre-incision time intervals (arrival latency, anesthesia lead time, operating-room preparation, and surgery lead time)

Outcome

Salvage versus failure (total loss)hard clinical

Main Result

p-value: p=0.89

Pre-incision delays were not associated with free-flap salvage failure, suggesting quality improvement should focus on rapid recognition and anesthesia-surgery coordination rather than ward-to-incision logistics.

Cite This Study

Fiedler et al. (2026) conducted a cohort in Free flap vascular compromise (n=113). Pre-incision delays was evaluated on Salvage versus failure (total loss) (p=0.89). Pre-incision delays were not associated with free-flap salvage failure (14.2% total loss rate), with median registration-to-incision times similar between salvage and failure (78 vs 77 min, p=0.89).

synapsesocial.com/papers/6aa7afef79e9260bc85aac93 https://doi.org/10.1002/micr.70292

View Full Paper

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September 14, 2026MicrosurgeryOpen Access

Pre‐Incision Time Intervals and Outcomes of Free Flap re‐Exploration: A Retrospective Single‐Center Study

View Full Paper

Ask AI

Bookmark

Key result

Pre-incision delays show no association with free-flap salvage failure.

P=0.89
n=113

Why the study?

Are pre-incision delays associated with free-flap salvage failure in patients undergoing free-flap revision surgery?

Population

113 free-flap revision surgeries performed over the past 6 years at a single center

Design

Cohort

Authors

AFAlexander Fiedler NINesrin Ibrahim MFMaria Fueth

Discussion

Member takes

Overview

Pre-incision delays may be associated with free-flap salvage failure; supports workflow targets but leaves open prospective validation.

Key Points

To determine whether pre-incision delays between surgery registration and incision correlate with free flap salvage failure and identify workflow targets for clinical improvement.
Retrospective single-center review of 113 free-flap revision surgeries conducted over 6 years.
Partitioned the registration-to-incision pathway into arrival latency, anesthesia lead time, operating room preparation, and surgery lead time to evaluate primary outcomes of salvage versus total flap loss.
Total flap loss occurred in 14.2% of re-explorations, with no significant difference in median registration-to-incision time between flap salvage and failure (78 min vs. 77 min, p = 0.89).
No significant differences occurred across transit and preparation sub-intervals, including arrival latency (19 min vs. 20 min, p = 0.89), operating room preparation (25 min vs. 22 min, p = 0.66), and door-to-incision duration (52 min vs. 53 min, p = 0.50).
Failures trended toward longer anesthesia lead times (38 vs. 28 min, p = 0.48), longer operative durations (109 vs. 83 min, p = 0.12), and weekend procedures (25% vs. 12%, p = 0.06).

Study Design

Type

Cohort (n=113)

Multicenter

Structured PICO

Are pre-incision delays associated with free-flap salvage failure in patients undergoing free-flap revision surgery?

Population

113 free-flap revision surgeries performed over 6 years to evaluate pre-incision time intervals and outcomes.

Exposure

Pre-incision time intervals (arrival latency, anesthesia lead time, operating-room preparation, and surgery lead time)

Outcome

Salvage versus failure (total loss)hard clinical

Main Result

p-value: p=0.89

Cite This Study

synapsesocial.com/papers/6aa7afef79e9260bc85aac93 https://doi.org/10.1002/micr.70292

Also Consider

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