HYPOALBUMINEMIA IN MICROSURGICAL FLAPS OF THE MUSCULOSKELETAL APPARATUS

ABSTRACT Objective: To evaluate if the levels of serum total protein and serum albumin are risk factors for surgical complications of free flap limb reconstruction. Methods: Consecutive inclusion of all patients undergoing microsurgical flaps for limb reconstruction of complex injuries. We recorded epidemiological and laboratory data, including total proteins and fractions, for descriptive and analytical statistics. Results: Our study analyzed one microsurgical flap from 35 patients that underwent complex injuries of the limbs. In total, 23 patients were men, and mean age of all patients was 35 years. After statistical analysis, no influence of pre or postoperative hypoalbuminemia was observed on the incidence of complications. Patients with hypoalbuminemia had a higher length of stay than those with normal albumin levels (p = 0.008). Conclusion: We observed that 71% of patients had hypoalbuminemia in early postoperative period and we suggest a nutritional support for patients requiring complex traumatic limb reconstruction. Hypoalbuminemia in patients subjected to microsurgical flaps for the treatment of complex traumatic limb injuries did not influence the complications that required surgical reintervention; However, it was associated with prolonged hospital stay. Level of Evidence II, Retrospective study.

摘要 目的：探讨血清总蛋白（serum total protein）与血清白蛋白（serum albumin）水平是否为游离皮瓣（free flap）肢体重建手术并发症的危险因素。
方法：连续纳入所有因肢体复杂损伤接受显微外科皮瓣（microsurgical flaps）肢体重建手术的患者，收集其流行病学资料与实验室检测数据（包括总蛋白及其组分），用于描述性与分析性统计分析。
结果：本研究对35例肢体复杂损伤患者的显微外科皮瓣手术资料进行分析，其中男性23例，患者平均年龄为35岁。经统计学分析，术前或术后低白蛋白血症（hypoalbuminemia）对手术并发症发生率无显著影响；但低白蛋白血症患者的住院时长（length of stay）显著长于白蛋白水平正常者（p=0.008）。
结论：本研究发现71%的患者在术后早期出现低白蛋白血症，建议对需接受复杂创伤肢体重建手术的患者提供营养支持。接受显微外科皮瓣手术治疗复杂创伤肢体损伤的患者中，低白蛋白血症并未对需手术再次干预的并发症发生率产生影响，但与住院时长延长相关。本研究为回顾性研究（retrospective study），证据等级为Ⅱ级（Level of Evidence Ⅱ）。