Protein C deficiency in microvascular head and neck reconstruction.

OBJECTIVE

To determine the incidence of perioperative protein C deficiency in patients undergoing free flap reconstruction of cancer-related defects in the head and neck.

STUDY DESIGN

Prospective case series.

INTERVENTION

Ten patients underwent microvascular reconstruction after surgical therapy of carcinomas of the oral cavity or oropharynx. Coagulation studies were determined in all patients 72 hours after surgery.

SETTING

Academic tertiary care medical center

RESULTS

Protein C deficiency was detected in 70% of patients. One free flap failure was attributed to protein C deficiency.

CONCLUSIONS

Vitamin K-dependent clotting factors are frequently deficient during the postoperative period after major head and neck surgery, which may result in a state of hypercoagulability. Protein C deficiency should be considered as a possible cause of free flap thrombosis in patients who undergo microvascular head and neck reconstruction.