Hand Surgery and Microsurgery Division, Department of Plastic and Reconstructive Surgery, Hospital de San José, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia.
Department of Plastic and Reconstructive Surgery, Hospital de San José. Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia.
J Reconstr Microsurg. 2022 Jun;38(5):402-408. doi: 10.1055/s-0041-1733994. Epub 2021 Sep 2.
Free flaps have become a highly valuable tool for complex reconstructive surgeries. The requirement of red blood cell transfusion (RBCT) during the perioperative period is common and its effect on the free flap survival is debatable. The aim of this study was to determine the relationship between perioperative RBCT and vascular pedicle thrombosis (VPT).
For this study 302 free flaps performed between January 2006 and December 2019 were retrospectively analyzed. It included their characteristics from before, during, and after the surgical procedure. The incidence of VPT and flap survival were calculated based on Kaplan Meier's method and the relationship between VPT and perioperative variables were analyzed by Cox regression models.
The transfusion group was represented by 62 flaps (20.5%) and no transfusion by 240 flaps. The overall transfusion requirement was 20.5% and the cumulative incidence of VPT was 9.11%. A statistically significant relationship was not demonstrated between flap survival and transfusion status (HR = 1.73 IC 95%: 0.5 to 3.96; = 0.192) ( = 0.192) independently from the number of units transfused, the preoperative diagnosis of anemia, and the type of flap used and did not establish an increased risk of VPT.
This study did not demonstrate an association between RBCT during preoperative period and the risk for VPT or microvascular free flap survival rate on postoperative follow up.
游离皮瓣已成为复杂重建手术的一种非常有价值的工具。围手术期需要输血（RBCT）是常见的，其对游离皮瓣存活的影响存在争议。本研究旨在确定围手术期 RBCT 与血管蒂血栓形成（VPT）之间的关系。
本研究回顾性分析了 2006 年 1 月至 2019 年 12 月期间进行的 302 例游离皮瓣手术。包括手术前后的特征。根据 Kaplan-Meier 方法计算 VPT 和皮瓣存活的发生率，并通过 Cox 回归模型分析 VPT 与围手术期变量之间的关系。
输血组有 62 例皮瓣（20.5%），未输血组有 240 例皮瓣。总的输血需求为 20.5%，VPT 的累积发生率为 9.11%。皮瓣存活率与输血状态之间无统计学显著相关性（HR=1.73，95%CI：0.5 至 3.96；=0.192）（=0.192），与输血量、术前贫血诊断和使用的皮瓣类型无关，也不会增加 VPT 的风险。
本研究未发现术前 RBCT 与 VPT 风险或术后随访中微血管游离皮瓣存活率之间存在关联。
