Successful microvascular surgery in patients with thrombophilia in head and neck surgery: a case series

In this case series, a perioperative anticoagulation protocol for microvascular head and neck surgery in patients with thrombophilia is presented. Microvascular free-flap surgery is a standard procedure in head and neck surgery with high success rates. Nevertheless, flap loss-which is most often cau...

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Bibliographic Details
Published in:Journal of medical case reports 2024-02, Vol.18 (1), p.119-119, Article 119
Main Authors: Faber, Julian, Schuster, Frank, Hartmann, Stefan, Brands, Roman C, Fuchs, Andreas, Straub, Anton, Fischer, Markus, Müller-Richter, Urs, Linz, Christian
Format: Article
Language:English
Subjects:
Anticoagulants
Anticoagulation
Blood clot
Blood diseases
Care and treatment
Case Report
Case reports
Factor V Leiden mutation
Free flap
Head
Head and neck
Microsurgery
Microvascular surgery
Mutation
Neck
Patients
Perioperative care
Questionnaires
Surgeons
Thrombophilia
Thrombosis
Tracheotomy
Transplants & implants
Vascular surgery
White people
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Summary:In this case series, a perioperative anticoagulation protocol for microvascular head and neck surgery in patients with thrombophilia is presented. Microvascular free-flap surgery is a standard procedure in head and neck surgery with high success rates. Nevertheless, flap loss-which is most often caused by thrombosis-can occur and has far-reaching consequences, such as functional impairment, prolonged hospitalization, and increased costs. The risk of flap loss owing to thrombosis is significantly increased in patients with thrombophilia. Therefore, perioperative anticoagulation is mandatory. To date, no perioperative anticoagulation protocol exists for these high-risk patients. We present three exemplary male Caucasian patients aged 53-57 years with free flap loss owing to an underlying, hidden thrombophilia. We present a modified anticoagulation protocol for microvascular surgery in these high-risk patients, enabling successful microsurgical reconstruction.
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-024-04403-8