Hardware Complication Risks in Head and Neck Cancer Patients Undergoing Reconstructive Surgery With Segmental Mandibulectomy

Background: The primary objective of this study was to ascertain the risk factors associated with hardware complications following segmental mandibular reconstruction in head and neck cancer patients. Additionally, we sought to develop a nomogram model that enables accurate risk prediction. Methods: Patients who underwent segmental mandibulectomy with immediate free or local regional tissue transfer between January 2016 and December 2020 were reviewed. Hardware complications were defined. Patient demographics and perioperative parameters were analyzed. Results: A total of 510 patients were analyzed. Postoperative radiation therapy (OR = 2.296, 95% CI = 1.339–3.938, p = 0.003), postoperative wound infection (OR = 2.367, 95% CI = 1.472–3.806, p < 0.001), and debridement for flap-related complications (OR = 5.484, 95% CI = 3.269–9.199, p < 0.001) were identified as independent risk factors. The nomogram model demonstrated good discriminatory ability. Conclusion: This comprehensive analysis identified three independent risk factors, and the nomogram provides a valuable tool for predicting the risks. Further research is needed to validate these findings and explore preventive strategies.