Autologous Breast Reconstruction Success Rates in Hypercoagulable Patients.

Autor:	Egan KG; From the Departments of Plastic Surgery., Elver AA; From the Departments of Plastic Surgery., Birney JM; From the Departments of Plastic Surgery., Nazir N; Population Health, University of Kansas Medical Center., Butterworth JA; From the Departments of Plastic Surgery., Lai EC; Population Health, University of Kansas Medical Center.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery [Plast Reconstr Surg] 2024 Mar 01; Vol. 153 (3), pp. 516e-522e. Date of Electronic Publication: 2023 May 22.
DOI:	10.1097/PRS.0000000000010708
Abstrakt:	Background: Hypercoagulable disorders may adversely affect microsurgical outcomes, including increased flap failure and complication rates. Outcomes specific to autologous breast reconstruction are not well described. Methods: A retrospective review was performed of autologous breast reconstructions between 2009 and 2020. Patients with either a thrombophilic disorder (TD) diagnosis or a previous thrombotic event (TE) were identified. The analysis compared perioperative complications and flap success rates. Results: In this series, 23 patients with a TD underwent 39 flaps, and 78 patients who had experienced a TE underwent 126 flaps, compared with 815 control patients, who underwent 1300 flaps. In logistic regression models, a TD diagnosis was an independent predictor of early total flap loss [OR, 8.42 (95% CI, 1.59 to 44.47); P = 0.01], late partial flap loss [OR, 3.9 (95% CI, 1.0 to 15.22); P = 0.05], and delayed healing [OR, 2.26 (95% CI, 1.02 to 5.04); P = 0.04]. TE history trended toward an association only with late partial flap loss ( P = 0.057). Flap salvage rates (25%) and flap success rates (92.3%) were statistically lower in patients with a TD but normal in patients who had experienced a TE. Conclusions: Microsurgical breast reconstruction is a reasonable option for patients with hypercoagulation disorders. No increased risk of flap complications was associated with a previous TE; however, TDs carried increased risk. Clinical Question/level of Evidence: Risk, II. (Copyright © 2023 by the American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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