Consensus of free flap complications: Using a nomenclature paradigm in microvascular head and neck reconstruction

Background We aim to define a set of terms for common free flap complications with evidence-based descriptions. Methods Clinical consensus surveys were conducted among panel head and neck/reconstructive surgeons (N = 11). A content validity index relevancy clarity each item was computed adjusted chance agreement (modified kappa, K). Items K < 0.74 (i.e., ratings “good” or “fair”) eliminated. Results Five out nineteen scored 0.74. Eliminated included “vascular compromise”; “cellulitis”; “surgical site abscess”; “malocclusion”; “non- mal-union.” Terms that achieved “total/partial failure”; “free takeback”; “arterial thrombosis”; “venous “revision microvascular anastomosis”; “fistula”; “wound dehiscence”; “hematoma”; “seroma”; “partial skin graft “total “exposed hardware bone”; “hardware failure.” Conclusion Standardized reporting would encourage multi-institutional research collaboration, larger scale quality improvement initiatives, the ability risk-adjusted benchmarks, enhance education communication.