Microvascular Surgeons: The Second Victim With Free Flap Failure.

[OBJECTIVE] Second victim syndrome (SVS) is when a health care provider involved in a patient complication is traumatized by the event, manifesting as symptoms of anxiety, depression, and shame. We investigated microvascular surgeons' emotional responses to free flap failure and their emotional support systems.

[METHODS] Twenty-question survey of microvascular surgeons. Questions focused on participant demographics and practice dynamics, emotional responses to free flap failure, and emotional support systems.

[RESULTS] Ninety-three surgeons completed the survey and reported emotional responses to free flap failure. Survey response rate was 47.6%. Most (83.9%) practiced in an academic setting. Over half of surgeons reported anxiety (74%), guilt (70%), sadness (68%), shame or embarrassment (63%) and doubt (51%) following flap failure. Females were statistically more likely to report sadness (82% vs. 58.1%, p = 0.018) and doubt their surgical acumen (61.8% vs. 34%, p = 0.011) compared to men. Women rated therapists (3.88 vs. 2.07, p = 0.004) and online forums (6.18 vs. 1.64, p < 0.011) to be better support systems than those reported by men. Surgeons who had a recent free flap failure in the last 6 months expressed a desire to decrease free flap volume compared to those who had a free flap failure > 6 months (34% vs. 14%, p = 0.047).

[CONCLUSION] Flap failure results in SVS for microvascular surgeons of all ages, gender, and geographic distributions. Interventions during the first 6 months after a free flap failure may be most beneficial to microsurgeons going through an emotionally challenging time.

[LEVEL OF EVIDENCE] N/A.