Journal of Tissue Engineering and Reconstructive Surgery ›› 2024, Vol. 20 ›› Issue (3): 305-.

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Risk factors analysis and predictive model construction for the failure of free flap transplantation in patients with traumatic soft tissue injury of limbs

  

  • Online:2024-06-01 Published:2024-07-05

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Abstract:

Objective To explore the risk factors for failure of free flap transplantation （FFT） in patients with traumatic
soft tissue injury （STI） of limbs， and to construct a predictive model. Methods A total of 575 patients with traumatic STI in
the limbs who underwent FFT from January 2017 to June 2023 were regarded as the study subjects. The patients were
randomly separated into a modeling group （n=403） and a validation group （n=172） at 7：3. Multivariate Logistic regression
analysis was applied to determine the risk factors for FFT repair failure in patients with traumatic STI of the limbs. The RMS
program package in R3.6.3 software was applied to construct a column graph model for predicting the failure of FFT repair in
patients with traumatic STI of limbs， receiver operating characteristic （ROC） curve and the Hosmer-Lemeshow （H-L） fit
curve were applied to evaluate the discrimination and consistency of the column plot model prediction. Results The results
of multivariate Logistic regression analysis showed that the time from injury to surgery ≥ 6 hours （OR=2.179）， unreasonable
selection of anastomosis vessels （OR=6.770）， concurrent infection （OR=4.980）， incomplete intraoperative hemostasis （OR=
3.054）， and unstable postoperative fixation （OR=2.132） were all independent risk factors for FFT repair failure in patients
with traumatic STI of limbs （P<0.05）
.
The H-L test of the modeling group showed χ2 =11.889，P=0.546， and the area under
the ROC curve was 0.809（95% CI：0.748-0.869）； The H-L test of the validation group showed χ2 =6.990，P=0.322， and
the area under the ROC curve was 0.827（95% CI：0.722-0.932）
.
Conclusion Based on five risk factors： Time from injury
to surgery， selection of anastomotic vessels， concurrent infection， incomplete intraoperative hemostasis， and unstable
postoperative fixation， the column chart model for predicting the failure of FFT repair in patients with traumatic STI of limbs
has good discrimination and consistency

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