Preoperative anemia predicts thrombosis and free flap failure in microvascular reconstruction. Ann Plast Surg 2012 Oct;69(4):364-7
Date
09/12/2012Pubmed ID
22964664DOI
10.1097/SAP.0b013e31823ed606Scopus ID
2-s2.0-84866610023 (requires institutional sign-in at Scopus site) 55 CitationsAbstract
Patients undergoing microvascular reconstruction are often anemic from a combination of iatrogenic hemodilution and acute blood losses. No major clinical study describes the impact of preoperative anemia on free flap morbidity. The plastic surgery service at a high-volume academic center performed 156 free flaps among 147 patients from December 2005 to December 2010. One hundred thirty-two had a preoperative hemoglobin (Hb) or hematocrit (Hct), with mean values of 11.8±2.4 g/dL and 35.2%±7.0%, respectively. The overall failure rate was 9% (12/132), primarily from vascular thrombosis (6/12). Through logistic regression analysis, Hb and Hct were significant predictors of flap failure (P<0.005) and vascular thrombosis (P<0.05). Fisher exact test revealed a significant increase in failure risk at Hct level less than 30% (Hb<10 g/dL) (relative risk, 4.76, P=0.006), and probit analysis demonstrated an exposure-response relationship to decreased Hct level (P<0.005). These findings support that preoperative anemia could significantly impact free flap morbidity.
Author List
Hill JB, Patel A, Del Corral GA, Sexton KW, Ehrenfeld JM, Guillamondegui OD, Shack RBAuthor
Jesse Ehrenfeld MD, MPH Sr Associate Dean, Director, Professor in the Advancing a Healthier Wisconsin Endowment department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AnemiaBiomarkers
Female
Free Tissue Flaps
Graft Survival
Hematocrit
Hemoglobins
Humans
Logistic Models
Male
Microvessels
Middle Aged
Necrosis
Postoperative Complications
Preoperative Period
Retrospective Studies
Risk Factors
Thrombosis
