Davis Michael Robert, Shell Daniel Huff, Marques Marisa, Long James Neal
Division of Plastic Surgery, University of Alabama at Birmingham, School of Medicine, Birmingham, AL 35294-3411, USA.
Microsurgery. 2009;29(1):62-5. doi: 10.1002/micr.20553.
Much has been learned over the past several decades regarding thrombophilic conditions. Thrombotic complications, such as deep venous thrombosis, pulmonary embolus, myocardial infarction, and stroke, are sometimes attributed to a diagnosable thrombophilia. Less has been written with regard to their effect on reconstructive outcomes. Fortunately, it is rare to encounter a notable intraoperative thrombophilia while performing reconstructive microsurgery. When this does occur, salvage can be difficult and outcome can be compromised. It is imperative that microsurgeons be knowledgeable of both major and minor thrombogenic conditions to optimize intraoperative outcome and postoperative care. We present a case of a failed free flap for lower extremity reconstruction associated with hyperhomocysteinemia in conjunction with markedly elevated Factor VIII levels.
在过去几十年里，我们对血栓形成倾向疾病有了很多了解。血栓形成并发症，如深静脉血栓、肺栓塞、心肌梗死和中风，有时可归因于可诊断的血栓形成倾向。关于它们对重建手术结果的影响，相关论述较少。幸运的是，在进行重建显微手术时，很少会遇到明显的术中血栓形成倾向。当这种情况确实发生时，挽救可能会很困难，结果也可能受到影响。显微外科医生必须了解主要和次要的血栓形成情况，以优化术中结果和术后护理。我们报告一例因高同型半胱氨酸血症合并因子VIII水平显著升高导致下肢重建游离皮瓣失败的病例。
