American Society of Hirudotherapy

Is the preoperative MPV value related to early thrombus formation in microvascular anastomosis?

Research article published in Journal of plastic surgery and hand surgery (2016)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportClinical TrialsEser C et al. · Journal of plastic surgery and hand surgery, 2016

Abstract

OBJECTIVE: One of the most common encountered problems in free flap surgeries is anastomotic thrombosis. The mean platelet volume (MPV) may indicate the concentration of intra-platelet proactive substances and the thrombogenic potential of the platelets. MPV is used as a clinical monitoring index in routine blood counts, it has not yet been effectively used in free flap surgery. METHODS: This study evaluates the relationship between the preoperative MPV value and anastomotic thrombus formation during the postoperative 48 hours in 32 free flap operations from September 2013 to September 2014. The mean patient age was 36.75 years. The preoperative MPV value, which was obtained from the complete blood count, was recorded and correlation of MPV and postoperative thrombus formation was investigated. RESULTS: Four anastomotic thrombus were encountered in 34 free flaps during the postoperative 48 hours. Two of them were salvaged by performing thrombectomy and/or administration of i.v. heparin. There was no statistical relationship between MPV value and postoperative thrombus formation during 48 hours follow-up (p = 0.925). CONCLUSION: Even though this study didn't find a correlation between preoperative MPV value and postoperative early anastomotic thrombus, it would be helpful to validate the results using multi-centre and comprehensive studies with larger patient cohorts.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal Article
Indexed MeSH termsAdultAnastomosis, SurgicalFemaleFree Tissue FlapsHumansMaleMean Platelet VolumeMicrosurgeryPostoperative ComplicationsPreoperative PeriodThrombosis

Summary

Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

Why This Matters for Hirudotherapy

This study examined whether preoperative mean platelet volume (MPV) predicts early anastomotic thrombosis in 32 free-flap operations, recording 4 anastomotic thrombi within the first 48 postoperative hours (two salvaged by thrombectomy and/or IV heparin) and finding no statistically significant association between MPV and thrombus formation (p = 0.925). This is squarely within hirudotherapy's core clinical setting: free-flap and microvascular surgery is exactly where medicinal leeches are deployed to relieve venous congestion and rescue a failing flap, so any marker that flags thrombotic risk early would complement leech-based salvage. The honest caveat is that this is a small single-arm study of 32 flaps with a negative result, and the authors themselves call for larger multicentre validation; it neither supports MPV as a useful predictor nor evaluates leech therapy.

Citation

Is the preoperative MPV value related to early thrombus formation in microvascular anastomosis?.

Eser C et al. · Journal of plastic surgery and hand surgery, 2016

Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026

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