Journal of Surgical Simulation 2021; 8: A: 6 - 6

Published: 30 June 2021


Meeting abstract

Special Issue: Intraoperative albumin usage and free flap outcomes in UMMC

Lingwei Wong, Kong Chee Kwan and Alizan Abdul Khalil
Corresponding author: Lingwei Wong, UMMC, Malaysia. Email:


Microvascular free flaps are the preferred method of reconstruction. Free flap failure is defined as complete necrosis of the flap. Free flap failure rates reported in the literature are about 5% and is 13.1% in Malaysia. A failed free flap causes long term morbidity and prolonged hospital stay. There are many factors that can result in free flap failure. Albumin is used in fluid resuscitation, sepsis and critically ill patients. It reduces the amount of fluid needed to achieve the desired stroke volume and postulated to improve micro perfusion in free flap.

Data on patients that underwent free flap from 2012 to 2019 in University Malaya Medical Centre (UMMC) were collected. Demographic data, usage of intraoperative albumin and predictors for free flap failure are collected.

A total of 108 patients underwent free flap in UMMC from 2012-2019. Data on usage of intraoperative albumin were obtained in 89 patients. 59 patients had intraoperative albumin and 30 patients did not receive intraoperative intravenous albumin. Flap failure rate in the albumin group was 11.9% and flap failure rate in the no albumin group was 23.3%. Multiple logistic regression was done, and it shows that no albumin use, and prolonged operative time are the significant predictors of free flap failure in UMMC.

Usage of intraoperative albumin is beneficial in free flap surgery in our study, but more prospective studies and randomized controlled trial should be done to come to a stronger conclusion. 


microvascular free flap; albumin; University Malaya Medical Centre ; flap failure

Additional Information

This presentation was given at the SES 2020 online conference, 4 July 2020.