Sanchez-Porro Gil Lidia, Leon Vintro Xavier, Lopez Fernandez Susana, Vega Garcia Carmen, Pons Playa Gemma, Fernandez Garrido Manuel, Masia Ayala Jaume
Department of Plastic and Reconstructive Surgery, Hospital Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain.
Department of Otolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain.
J Clin Med. 2021 Mar 23;10(6):1333. doi: 10.3390/jcm10061333.
Perioperative transfusions are associated with complications of free flaps. The purpose of the present study was to find out whether there is a significant relationship between the risk of developing complications in vascular anastomoses and the history of transfusions.
We studied 372 patients retrospectively with microsurgical reconstruction between 2009 and 2017 with regards to the number of red blood cell concentrates transfused. Complications were analyzed relative to flap loss and complications in microvascular anastomoses.
130 patients (34.9%) received blood transfusions. Some 55% of them were transfused between the day of the intervention and the first postoperative day. Ninety-six patients were reoperated on (25.7%). Of those, thirty-six patients (37.5%) corresponded to anastomosis failure. The percentage of patients transfused among those who required reoperation was 55.2%. The percentage of patients transfused among those who were reoperated on within the first 72 h due to an alteration in the anastomosis was 60.6%, while it was 25.6% (Chi square P = 0.0001) for the rest of the patients.
Although there is a strong association between transfusion and vascular anastomosis failure, it is not possible to establish the causation between the two.
围手术期输血与游离皮瓣并发症相关。本研究的目的是确定血管吻合术中发生并发症的风险与输血史之间是否存在显著关系。
我们回顾性研究了2009年至2017年间372例行显微外科重建手术的患者的红细胞浓缩液输注数量。分析了与皮瓣丢失和微血管吻合术中并发症相关的情况。
130例患者（34.9%）接受了输血。其中约55%在干预当天至术后第一天之间输血。96例患者接受了再次手术（25.7%）。其中，36例患者（37.5%）吻合失败。需要再次手术的患者中输血患者的比例为55.2%。因吻合口改变在术后72小时内接受再次手术的患者中输血患者的比例为60.6%，而其余患者中这一比例为25.6%（卡方检验P = 0.0001）。
虽然输血与血管吻合失败之间存在密切关联，但无法确定两者之间的因果关系。
