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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 |
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container_title | American journal of otolaryngology |
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creator | 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. |
description | 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 |
doi_str_mv | 10.1016/j.amjoto.2020.102404 |
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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 < .001) and DVT prophylaxis (p = .03) were significantly associated with hematoma formation (OR 95% CI 12.23 (4.98–30.07), 3.46 (1.15–10.44) respectively) on multivariable analysis.
Heparin Drips and DVT prophylaxis significantly increased hematoma rates in free flap patients while tourniquets did not affect rates of hematoma.</description><identifier>ISSN: 0196-0709</identifier><identifier>EISSN: 1532-818X</identifier><identifier>DOI: 10.1016/j.amjoto.2020.102404</identifier><identifier>PMID: 32001026</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>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</subject><ispartof>American journal of otolaryngology, 2020-05, Vol.41 (3), p.102404-102404, Article 102404</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><rights>2020. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-bbe5dfb3484f60626f77632f314d8811ff0694d2160139b507b963be9365edd43</citedby><cites>FETCH-LOGICAL-c390t-bbe5dfb3484f60626f77632f314d8811ff0694d2160139b507b963be9365edd43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32001026$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Britt, Christopher J.</creatorcontrib><creatorcontrib>Hwang, Michelle S.</creatorcontrib><creatorcontrib>Vila, Peter M.</creatorcontrib><creatorcontrib>Dang, Rajan P.</creatorcontrib><creatorcontrib>Fleming, Shannon I.</creatorcontrib><creatorcontrib>Patel, Aman M.</creatorcontrib><creatorcontrib>Paniello, Randal C.</creatorcontrib><creatorcontrib>Rich, Jason T.</creatorcontrib><creatorcontrib>Hanasono, Matthew M.</creatorcontrib><creatorcontrib>Desai, Shaun C.</creatorcontrib><title>Tourniquet use and factors associated with hematoma formation in free tissue transfer</title><title>American journal of otolaryngology</title><addtitle>Am J Otolaryngol</addtitle><description>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 < .001) and DVT prophylaxis (p = .03) were significantly associated with hematoma formation (OR 95% CI 12.23 (4.98–30.07), 3.46 (1.15–10.44) respectively) on multivariable analysis.
Heparin Drips and DVT prophylaxis significantly increased hematoma rates in free flap patients while tourniquets did not affect rates of hematoma.</description><subject>Anticoagulants</subject><subject>Demographic variables</subject><subject>Demography</subject><subject>Dissection</subject><subject>Fibula</subject><subject>Forearm</subject><subject>Head and neck</subject><subject>Hematoma</subject><subject>Heparin</subject><subject>Identification methods</subject><subject>Ischemia</subject><subject>Neck</subject><subject>Patients</subject><subject>Prophylaxis</subject><subject>Regression analysis</subject><subject>Risk factors</subject><subject>Statistical analysis</subject><subject>Thrombosis</subject><subject>Tissues</subject><subject>Tourniquets</subject><issn>0196-0709</issn><issn>1532-818X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kEtr3TAQRkVJaW7T_oNSBNl049vRw7K1CYTQFwS6SaA7IVsjInNtJZKc0n9fXZxmkUVXI4bzzWgOIR8Y7Bkw9Xna23mKJe458GOLS5CvyI61gjc963-dkB0wrRroQJ-StzlPACCkaN-QU8EBakLtyO1NXNMSHlYsdM1I7eKot2OJKVObcxyDLejo71Du6B3OtsTZUh9TfYW40LBQnxBpCTmvtSS7ZI_pHXnt7SHj-6d6Rm6_frm5-t5c__z24-ryuhmFhtIMA7bOD0L20itQXPmuU4J7waTre8a8B6Wl40wBE3pooRu0EgNqoVp0Tooz8mmbe59iPSEXM4c84uFgF4xrNly0AL3uVVfR8xfodLy8_s5wyVvVc93ySsmNGlPMOaE39ynMNv0xDMxRu5nMpt0ctZtNe419fBq-DjO659A_zxW42ACsNh4DJpPHgMuILiQci3Ex_H_DX9fTlHs</recordid><startdate>20200501</startdate><enddate>20200501</enddate><creator>Britt, Christopher J.</creator><creator>Hwang, Michelle S.</creator><creator>Vila, Peter M.</creator><creator>Dang, Rajan P.</creator><creator>Fleming, Shannon I.</creator><creator>Patel, Aman M.</creator><creator>Paniello, Randal C.</creator><creator>Rich, Jason T.</creator><creator>Hanasono, Matthew M.</creator><creator>Desai, Shaun C.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7QR</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20200501</creationdate><title>Tourniquet use and factors associated with hematoma formation in free tissue transfer</title><author>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.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-bbe5dfb3484f60626f77632f314d8811ff0694d2160139b507b963be9365edd43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Anticoagulants</topic><topic>Demographic variables</topic><topic>Demography</topic><topic>Dissection</topic><topic>Fibula</topic><topic>Forearm</topic><topic>Head and neck</topic><topic>Hematoma</topic><topic>Heparin</topic><topic>Identification methods</topic><topic>Ischemia</topic><topic>Neck</topic><topic>Patients</topic><topic>Prophylaxis</topic><topic>Regression analysis</topic><topic>Risk factors</topic><topic>Statistical analysis</topic><topic>Thrombosis</topic><topic>Tissues</topic><topic>Tourniquets</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Britt, Christopher J.</creatorcontrib><creatorcontrib>Hwang, Michelle S.</creatorcontrib><creatorcontrib>Vila, Peter M.</creatorcontrib><creatorcontrib>Dang, Rajan P.</creatorcontrib><creatorcontrib>Fleming, Shannon I.</creatorcontrib><creatorcontrib>Patel, Aman M.</creatorcontrib><creatorcontrib>Paniello, Randal C.</creatorcontrib><creatorcontrib>Rich, Jason T.</creatorcontrib><creatorcontrib>Hanasono, Matthew M.</creatorcontrib><creatorcontrib>Desai, Shaun C.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of otolaryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Britt, Christopher J.</au><au>Hwang, Michelle S.</au><au>Vila, Peter M.</au><au>Dang, Rajan P.</au><au>Fleming, Shannon I.</au><au>Patel, Aman M.</au><au>Paniello, Randal C.</au><au>Rich, Jason T.</au><au>Hanasono, Matthew M.</au><au>Desai, Shaun C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tourniquet use and factors associated with hematoma formation in free tissue transfer</atitle><jtitle>American journal of otolaryngology</jtitle><addtitle>Am J Otolaryngol</addtitle><date>2020-05-01</date><risdate>2020</risdate><volume>41</volume><issue>3</issue><spage>102404</spage><epage>102404</epage><pages>102404-102404</pages><artnum>102404</artnum><issn>0196-0709</issn><eissn>1532-818X</eissn><abstract>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 < .001) and DVT prophylaxis (p = .03) were significantly associated with hematoma formation (OR 95% CI 12.23 (4.98–30.07), 3.46 (1.15–10.44) respectively) on multivariable analysis.
Heparin Drips and DVT prophylaxis significantly increased hematoma rates in free flap patients while tourniquets did not affect rates of hematoma.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32001026</pmid><doi>10.1016/j.amjoto.2020.102404</doi><tpages>1</tpages></addata></record> |
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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 |
title | Tourniquet use and factors associated with hematoma formation in free tissue transfer |
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