Parameters predicting complications in flap surgery

Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 May;115(5):589-94. doi: 10.1016/j.oooo.2012.09.007. Epub 2012 Dec 12.

Abstract

Objectives: The aim of this prospective study was to determine laboratory parameters predicting complications and/or failure in flap surgery.

Study design: Fifty-seven patients undergoing reconstructive surgery with cutaneous free and pedicled flaps were included. Blood samples were taken 2 days before surgery and 1, 3, 5, 7, and 14 days after. Parameters associated with thrombophilia, bleeding disorders, and wound healing were determined.

Results: In 45 (77%) of 57 patients no complications occurred. Bleeding (9%) and venous thrombosis of the flaps (9%) led in 18% of the cases to surgical revisions. Activated protein C resistance showed a significant (P < .05) cluster in cases with venous thrombosis, whereas it was absent in all other cases. Fibrinogen, factor VIII:C, von Willebrand factor (vWF) activity, and VWF antigen were significantly (P < .05) higher in patients with venous thrombosis compared with all other patients.

Conclusions: Laboratory parameters of thrombosis and bleeding appear to be associated with complications in flap surgery.

Publication types

  • Comparative Study

MeSH terms

  • Activated Protein C Resistance / etiology
  • Blood Coagulation Tests
  • C-Reactive Protein / analysis
  • Factor VIII / analysis
  • Female
  • Fibrinogen / analysis
  • Follow-Up Studies
  • Forecasting
  • Free Tissue Flaps / adverse effects
  • Hematologic Tests
  • Hemorrhagic Disorders / blood
  • Humans
  • Male
  • Necrosis
  • Plastic Surgery Procedures* / adverse effects
  • Platelet Function Tests
  • Postoperative Complications*
  • Postoperative Hemorrhage / etiology
  • Prospective Studies
  • Reoperation
  • Skin Transplantation / adverse effects
  • Surgical Flaps* / adverse effects
  • Thrombophilia / blood
  • Thrombosis / blood
  • Thrombosis / etiology
  • Venous Thrombosis / blood
  • Venous Thrombosis / etiology
  • von Willebrand Factor / analysis
  • von Willebrand Factor / immunology

Substances

  • Von Willebrand antigen
  • von Willebrand Factor
  • Factor VIII
  • Fibrinogen
  • C-Reactive Protein