American Society of Hirudotherapy

Sarcopenia and microvascular free flap reconstruction.

Review published in Current opinion in otolaryngology & head and neck surgery (2021)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical TrialsChen et al. · Current opinion in otolaryngology & head and neck surgery, 2021

Abstract

PURPOSE OF REVIEW: This article reviews the recent literature regarding the impact of sarcopenia on microvascular free flap reconstruction outcomes. RECENT FINDINGS: Malnutrition, and consequent muscle loss, is a prevalent issue among head and neck cancer patients. However, diagnosis remains challenging due to a paucity of reliable objective measures. Traditional markers, such as albumin, have been used in the past to assess nutritional status, but cancer-related inflammation limits their predictive value. Recently, developments in the diagnosis of sarcopenia through the novel use of computed tomography (CT) cross-sectional muscle mass indices to evaluate body composition have proven effective and accessible. SUMMARY: Literature shows compelling evidence that sarcopenia is associated with higher rates of surgical complications that delay recovery and increase mortality. The use of CT imaging to quantify muscle loss offers an objective way to evaluate nutritional status, which is predictive of postoperative rates of complications. Research on ways to optimize muscle mass prior to surgery is limited, however, immunonutrition is emerging as a promising intervention that can attenuate sarcopenia-related inflammation to improve outcomes.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsCross-Sectional StudiesFree Tissue FlapsHead and Neck NeoplasmsHumansPlastic Surgery ProceduresSarcopenia

Summary

This article reviews the recent literature regarding the impact of sarcopenia on microvascular free flap reconstruction outcomes. Malnutrition, and consequent muscle loss, is a prevalent issue among head and neck cancer patients.

Why This Matters for Hirudotherapy

This review examines how sarcopenia impacts outcomes in microvascular free flap reconstruction, noting that muscle loss is associated with higher rates of surgical complications, delayed recovery, and increased mortality. The abstract focuses on preoperative nutritional status, CT-derived muscle mass indices, and the use of immunonutrition to improve surgical outcomes. It provides no discussion of specific flap salvage techniques, anticoagulation, or complications like venous congestion. Consequently, the article does not mention leeches, the leech secretome, or hirudotherapy, and possesses no defensible clinical relevance to the American Society of Hirudotherapy.

Citation

Sarcopenia and microvascular free flap reconstruction.

Chen et al. · Current opinion in otolaryngology & head and neck surgery, 2021

DOI

Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026

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