American journal of surgery · 2025
Strategies to minimize postoperative complications in microsurgical free tissue transfer: The role of anticoagulation, antiplatelets, and ambulation.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Shock Erika T, Porter Brooke E, Landwehr Farrell K, Atkinson Angela V, Raatz Natalie S, Klifto Kevin M, Willson Thomas D
Аннотация
OBJECTIVE: Microsurgical free tissue transfer (FTT) is essential in reconstructive surgery, but thromboembolic events are a leading cause of flap failure. This study evaluates how perioperative anticoagulation, antiplatelet therapy, and ambulation affect postoperative complications in FTT.
STUDY DESIGN: A retrospective cohort study of 497 free flap procedures assessed associations between antiplatelet and anticoagulation therapy, ambulation timing, and postoperative outcomes. The cohort included pediatric and adult patients who underwent a free tissue transfer from 2012 to 2021. Multivariable logistic regression identified predictors of flap-related complications.
RESULTS: Controlling for age, sex, and nicotine use, ambulation on postoperative day 1 was linked to reduced arterial/venous thrombosis (OR 0.34, p = 0.003) and fewer operating room takebacks (OR 0.56, p = 0.006). Anticoagulation on day 6 increased takeback odds (OR 1.64, p = 0.029). Antiplatelet therapy on day 7 decreased takeback odds (OR 0.65, p = 0.04). Day 7 ambulation lowered odds of any complication (aOR 0.67, p = 0.042).
CONCLUSIONS: Early mobilization and appropriately timed antithrombotic therapy reduce FTT complications, supporting standardized postoperative care.
STUDY DESIGN: A retrospective cohort study of 497 free flap procedures assessed associations between antiplatelet and anticoagulation therapy, ambulation timing, and postoperative outcomes. The cohort included pediatric and adult patients who underwent a free tissue transfer from 2012 to 2021. Multivariable logistic regression identified predictors of flap-related complications.
RESULTS: Controlling for age, sex, and nicotine use, ambulation on postoperative day 1 was linked to reduced arterial/venous thrombosis (OR 0.34, p = 0.003) and fewer operating room takebacks (OR 0.56, p = 0.006). Anticoagulation on day 6 increased takeback odds (OR 1.64, p = 0.029). Antiplatelet therapy on day 7 decreased takeback odds (OR 0.65, p = 0.04). Day 7 ambulation lowered odds of any complication (aOR 0.67, p = 0.042).
CONCLUSIONS: Early mobilization and appropriately timed antithrombotic therapy reduce FTT complications, supporting standardized postoperative care.