A nomogram for predicting free flap necrosis in soft tissue reconstruction of lower limbs: a retrospective cohort study - Summary - MDSpire

A nomogram for predicting free flap necrosis in soft tissue reconstruction of lower limbs: a retrospective cohort study

  • By

  • Cong Cheng

  • Xiaoyu Huang

  • Hai Liang

  • Zongyuan Jiang

  • May 26, 2026

  • 0 min

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Objective:

To identify independent risk factors for free flap necrosis in lower limb soft tissue reconstruction and to develop and internally validate a preliminary nomogram for risk prediction.

Key Findings:
  • {'text': 'Five independent risk factors for free flap necrosis were identified: Gustilo-Anderson classification IIIB/IIIC (OR = 3.74, 95% CI: 1.89–7.41), preoperative D-dimer > 0.5 mg/L (OR = 3.16, 95% CI: 1.50–6.64), preoperative albumin 6 h (OR = 2.59, 95% CI: 1.35–4.94), and defect size > 50 cm2 (OR = 2.05, 95% CI: 1.10–3.83).'}
Interpretation:

The developed nomogram incorporates five preoperative factors for predicting free flap necrosis and shows promising discriminative ability and clinical utility.

Limitations:
  • {'text': 'The study is limited by its retrospective design, which may affect the reliability of the findings and their applicability to broader clinical settings.'}
Conclusion:

The study developed and validated a preliminary nomogram for predicting free flap necrosis, demonstrating robust performance in a single-center cohort.

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