The effect of training level on complications after free flap surgery of the head and neck

Jacob S. Brady, Meghan M. Crippen, Andrey Filimonov, Neil V. Nadpara, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Objectives Analyze postoperative complications after free flap surgery based on PGY training level. Methods Data on free flap surgeries of the head and neck performed from 2005 to 2013 was collected from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Cases identifying the status of resident participation in the surgery and the PGY level were included. Results There were 582 cases with primary surgeon data available. 63 cases were performed with a junior resident, 211 were performed with the assistance of a senior resident, 279 cases were performed with a fellow, and 29 cases were performed by an attending alone without resident involvement. The overall complication rate was 55.2%. There was no statistically significant difference in the rate of complications between groups (47.6%, 59.7%, 53.0%, 58.6%, p = 0.277). After controlling for all confounding variables using multivariate analysis there was no significant difference in morbidity, mortality, readmissions, and reoperation amongst the groups. Furthermore, when comparing resident versus fellow involvement using multivariate analysis there were no significant differences in morbidity (OR = 0.768[0.522–1.129]), mortality (OR = 1.489[0.341–6.499]), readmissions (OR = 1.018[0.458–2.262]), and reoperation (OR = 0.863[0.446–1.670]). Conclusion Resident and fellow participation in microvascular reconstructive cases does not appear to increase 30-day rates of medical, surgical, or overall complications.

Original languageAmerican English
Pages (from-to)560-564
Number of pages5
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Issue number5
StatePublished - Sep 2017

ASJC Scopus subject areas

  • Otorhinolaryngology


  • Database
  • Facial plastics
  • Fellowship
  • Free flap
  • Otolaryngology
  • Reconstruction
  • Residency
  • Training level


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