Tourniquet use and factors associated with hematoma formation in free tissue transfer

Our objective was to understand which variables are associated with hematoma formation at both the donor and recipient sites in head and neck free tissue transfer and if hematoma rates are affected by tourniquet use. Patients were identified who underwent free tissue transfer at three institutions,...

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Published in:American journal of otolaryngology 2020-05, Vol.41 (3), p.102404-102404, Article 102404
Main Authors: Britt, Christopher J., Hwang, Michelle S., Vila, Peter M., Dang, Rajan P., Fleming, Shannon I., Patel, Aman M., Paniello, Randal C., Rich, Jason T., Hanasono, Matthew M., Desai, Shaun C.
Format: Article
Language:English
Subjects:
Anticoagulants
Demographic variables
Demography
Dissection
Fibula
Forearm
Head and neck
Hematoma
Heparin
Identification methods
Ischemia
Neck
Patients
Prophylaxis
Regression analysis
Risk factors
Statistical analysis
Thrombosis
Tissues
Tourniquets
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Summary:Our objective was to understand which variables are associated with hematoma formation at both the donor and recipient sites in head and neck free tissue transfer and if hematoma rates are affected by tourniquet use. Patients were identified who underwent free tissue transfer at three institutions, specifically either a radial forearm free flap (RFFF) or a fibula free flap (FFF), between 2007 and 2017. Variables including use of tourniquet, anticoagulation, treatment factors, demographics, and post-operative factors were examined to see if they influenced hematoma formation at either the free tissue donor or recipient site. 1410 patients at three institutions were included in the analysis. There were 692 (49.1%) RFFF and 718 (50.9%) FFF. Tourniquets were used in 764 (54.1%) cases. There were 121 (8.5%) hematomas. Heparin drips (p 
ISSN:0196-0709
1532-818X
DOI:10.1016/j.amjoto.2020.102404