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Baran D. Sumer, MD; Larry L. Myers, MD; Joseph Leach, MD; John M. Truelson, MD

Arch Otolaryngol Head Neck Surg. 2009;135(7):682-686.

Objective  To determine if intraoperative hypothermia correlates with perioperative complications in patients undergoing head and neck surgery with regional or free flap reconstructions.

Design  Retrospective medical chart review.

Setting  Academic tertiary care hospital.

Patients  A sample of 136 patients who underwent ablative surgery for head and neck cancer and subsequently required reconstruction with free tissue or a regional flap in the last 10 years.

Main Outcome Measures  Rate of early (within 3 weeks of surgery) perioperative complications and its correlation with patient hypothermia (core body temperature, <35°C).

Results  There were 43 patients with complications. Two patients died. Complications included 10 partial or total flap losses, 9 hematomas, 8 episodes of pneumonia, 7 fistulas, 7 wound infections, 5 wound breakdowns, and 2 cerebrospinal fluid leaks. Factors that did not correlate with complications included having received prior chemotherapy (P = .84), having stage IV cancer (P = .16), sex (P = .43), tobacco use (P = .58), prior radiotherapy (P = .30), the presence of comorbidities (P = .43), age (P = .27), length of surgery (P = .63), and the use of blood products perioperatively (P = .73). Patients who were hypothermic had a significantly higher rate of complications that normothermic patients (P = .002). Stepwise logistic regression analysis identified intraoperative hypothermia as a significant independent predictor for the development of early perioperative complications (odds ratio, 5.122; 95% confidence interval, 1.317-19.917).

Conclusions  Intraoperative hypothermia in head and neck surgery is correlated with perioperative complications. Maintaining normothermia through aggressive warming may decrease the incidence of perioperative morbidity for these patients.

Author Affiliations: Department of Otolaryngology–Head & Neck Surgery, University of Texas Southwestern Medical Center, Dallas.

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