Srikanthan Krithika, Viswanathan Nisha, Yuen James C
From the Division of Plastic Surgery, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR.
Ann Plast Surg. 2013 Dec;71(6):675-81. doi: 10.1097/SAP.0b013e3182586b47.
Free-tissue transfer has become routine surgery because of standardization of instrumentation, techniques, and training. The incidence of microvascular thrombosis leading to free-flap failure is relatively low; however, anastomotic thrombosis can still occur despite the best of circumstances. Although majority of the time it is due to technical mishap or misjudgment, free-flap failure can occur due to intrinsic factors, such as the patient's increased propensity to develop clots. We describe a case report of a patient with malignancy and multiple thrombophilias, which led to 2 successive failures in microvascular flap transfer to restore abdominal domain. The aim o f this article is to increase awareness of the potential for thrombophilias to cause a dismal outcome in free-tissue transfer. A review of the literature will be presented, and published cases of free-flap failure in patients with thrombophilia(s) will be summarized.
由于器械、技术和培训的标准化，游离组织移植已成为常规手术。导致游离皮瓣失败的微血管血栓形成发生率相对较低；然而，尽管在最佳情况下，吻合口血栓形成仍可能发生。虽然大多数情况下是由于技术失误或判断错误，但游离皮瓣失败也可能由于内在因素，如患者形成血栓的倾向增加。我们描述了一例患有恶性肿瘤和多种易栓症的患者的病例报告，该病例导致微血管皮瓣移植修复腹部区域连续两次失败。本文的目的是提高对易栓症在游离组织移植中导致不良后果可能性的认识。将对文献进行综述，并总结已发表的易栓症患者游离皮瓣失败的病例。
