Safety of Microvascular Free Tissue Transfer Reconstruction of the Head and Neck in the Setting of Chronic Pharmacologic Immunosuppression.

Background Patients on chronic pharmacologic immunosuppressive therapy are at increased risk of wound infection and complications after surgery. There is a paucity of data examining perioperative complications after microvascular free tissue transfer (MVFTT) reconstruction of the head and neck in this patient population. Methods Retrospective cohort study performed at two tertiary referral centers between August 2016 and May 2020. Results Nine hundred and seventy-nine patients underwent MVFTT during the study period; of these 47 (5%) patients were taking chronic immunosuppressive medications. The most common indications for immunosuppression were solid organ transplant and autoimmune disease. Fourteen (30%) patients had surgical complications within 30 days of surgery: 8 (17%) wound dehiscences, 6 (12%) hematomas, and 2 (4%) surgical site infections. There was one total and one partial flap failure with a 30-day reoperation rate of 4%. Conclusions MVFTT of the head and neck appears to be safe in patients on chronic pharmacologic immunosuppression.