Outcomes in Head and Neck Free Flap Reconstruction Among Patients With a History of Venous Thromboembolism.
Research article published in Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2021)
Abstract
OBJECTIVE: To investigate if a history of venous thromboembolism (VTE) is a risk factor for complications in head and neck free flap surgery by assessing outcomes among patients with a history of deep vein thrombosis (DVT) and/or pulmonary embolism (PE). STUDY DESIGN: Retrospective cohort study. SETTING: Single tertiary care center. METHODS: All patients undergoing head and neck free flap reconstruction at our institution between September 1, 2006, and April 2, 2020, were assessed for inclusion. Patients with and without a history of DVT or PE preoperatively were identified and grouped for comparison. Groups were compared for demographics, comorbidities, and 30-day complications. Significance was assessed with chi-square and binary logistic regression analyses. RESULTS: Of the 1061 patients meeting inclusion criteria, 40 (3.8%) had a history of VTE. These patients were significantly older (mean [SD], years: 67.8 [11.7] vs 63.0 [14.1], P = .038) and significantly more likely to have history of chemotherapy (35.0% vs 18.7%, P = .010) and stroke (27.5% vs 4.5%, P < .001). After accounting for patient characteristics via binary logistic regression, VTE was independently associated with an increased risk for postoperative thrombosis of the free flap pedicle (odds ratio [95% CI] = 3.65 [1.12-11.90], P = .032) and reoperation (2.45 [1.25-4.80], P = .009). Patients with history of PE had a significantly increased risk for flap failure (7.70 [1.77-33.52], P = .007). Prior VTE was not independently associated with an increased risk for medical complications or readmission. CONCLUSION: Patients with a history of VTE may be at an increased risk for free flap compromise secondary to postoperative pedicle thrombosis. This risk should be considered in preoperative workup and postoperative monitoring.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Резюме
To investigate if a history of venous thromboembolism (VTE) is a risk factor for complications in head and neck free flap surgery by assessing outcomes among patients with a history of deep vein thrombosis (DVT) and/or pulmonary embolism (PE). Retrospective cohort study.
Почему это важно для гирудотерапии
Это ретроспективное когортное исследование, включившее 1061 пациента с реконструкцией дефектов головы и шеи свободными лоскутами, показало, что предоперационный анамнез венозной тромбоэмболии был независимо ассоциирован с повышенным риском послеоперационного тромбоза сосудистой ножки свободного лоскута (OR 3,65) и повторной операции (OR 2,45), тогда как перенесённая тромбоэмболия лёгочной артерии специфически повышала риск потери лоскута (OR 7,70). Связь с предметной областью ASH носит косвенный характер: исследование посвящено тромботическим осложнениям в микрососудистой реконструкции — клиническому контексту, в котором медицинские пиявки иногда применяются для спасения лоскута при венозном застое. Тем не менее в статье не упоминаются пиявки, гирудотерапия или соединения, полученные из пиявок. Содержание статьи не поддерживает прямой релевантности помимо общей хирургической области, где терапия пиявками может служить одним из вспомогательных методов.
Цитирование
Outcomes in Head and Neck Free Flap Reconstruction Among Patients With a History of Venous Thromboembolism.
Crippen et al. · Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2021
Связанный клинический контекст
Узнайте, как это исследование связано с клинической практикой
Добавлено в библиотеку ASH: May 28, 2026 · Последнее обновление сайта: 18 июня 2026 г.