Plastic and reconstructive surgery · 2009
Microvascular free flap failure caused by unrecognized hypercoagulability.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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.
Davison Steven P, Kessler Craig M, Al-Attar Ali
Аннотация
BACKGROUND: Microvascular free flap techniques have improved over the past two decades such that flap failure rates have dropped to under 3 percent in most large series of high-volume centers. However, despite technical and patient-selection advances, some components of free flap failure might be attributable to undiagnosed patient factors.
METHODS: In this clinicopathologic conference article, the authors present four patients with major free flap microvascular complications who were later diagnosed with multiple risk factors for hypercoagulability and biochemical abnormalities, and present the characteristic associated findings.
RESULTS: Previously undiagnosed hypercoagulability was present in four patients with major free flap microvascular complications. Hematologic consultation and laboratory investigation revealed the biochemical abnormalities.
CONCLUSIONS: In certain patients undergoing microvascular free flap reconstruction, undiagnosed hypercoagulability risk factors can be a source of free flap failure that is independent of patient selection or technical factors. Diagnosis, management, patient counseling, and initiation of deep venous thromboembolism prophylaxis measures are critical clinical components of care of these patients.
METHODS: In this clinicopathologic conference article, the authors present four patients with major free flap microvascular complications who were later diagnosed with multiple risk factors for hypercoagulability and biochemical abnormalities, and present the characteristic associated findings.
RESULTS: Previously undiagnosed hypercoagulability was present in four patients with major free flap microvascular complications. Hematologic consultation and laboratory investigation revealed the biochemical abnormalities.
CONCLUSIONS: In certain patients undergoing microvascular free flap reconstruction, undiagnosed hypercoagulability risk factors can be a source of free flap failure that is independent of patient selection or technical factors. Diagnosis, management, patient counseling, and initiation of deep venous thromboembolism prophylaxis measures are critical clinical components of care of these patients.