Thrombotic Consequences of COVID-19 Infection on Microsurgical Reconstruction.

Autor: Han SH; Division of Plastic and Reconstructive Surgery, University of Chicago, Chicago, Illinois, USA., Ockerman K; Division of Plastic and Reconstructive Surgery, University of Chicago, Chicago, Illinois, USA., Kirchmier M; Division of Plastic and Reconstructive Surgery, University of Chicago, Chicago, Illinois, USA., Mardourian M; Division of Plastic and Reconstructive Surgery, University of Colorado, Aurora, Colorado, USA., Bryan J; Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, California, USA., Cox E; Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, California, USA., Chim H; Division of Plastic and Reconstructive Surgery, University of Florida, Gainesville, Florida, USA., Spiguel L; Division of Surgical Oncology, University of Florida, Gainesville, Florida, USA., Momeni A; Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, California, USA., Sorice-Virk S; Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, California, USA.
Jazyk: angličtina
Zdroj: Microsurgery [Microsurgery] 2024 Sep; Vol. 44 (6), pp. e31219.
DOI: 10.1002/micr.31219
Abstrakt: Background: Evidence has shown increased morbidity and mortality for patients with COVID-19 infection within 7 weeks of surgery. However, no studies have specifically investigated the effects of COVID-19 in microsurgical outcomes. This study evaluated thrombotic and overall complications after free tissue transfer for a variety of indications in patients with and without previous COVID-19 infection.
Methods: A retrospective cohort study was performed in adult patients with or without a history of COVID-19 infection who underwent microsurgical reconstruction between 2017 and 2022. Patients with a history of COVID-19 infection were matched to controls based on age, gender, race, body mass index, history of diabetes, coronary artery disease, hypertension, Caprini score, tobacco use, and flap indication.
Results: From 2017 to 2022, 35 patients had a documented history of COVID-19. Matched case analysis determined a 4.8 times increased odds ratio of postoperative complications in the COVID-19 group compared with controls (p = 0.002). Significantly, more patients with COVID-19 experienced total or partial flap loss and anastomotic issues (COVID-19: 7/35, Control: 0/35; p < 0.001). There was no significant difference in incidence of VTE (COVID-19: 1/35, Control: 0/35; p = 0.493). Of note, 62.9% of the COVID-19 group were discharged on anticoagulants (versus 14.3% in the control group [p < 0.001]).
Conclusion: COVID-19 has dire, long-lasting effects on virtually every organ system, chief among them, the microcirculation. Further studies are needed to fully determine the extent and influence of COVID-19 on complex procedures such as free tissue transfer and how to optimize the screening, workup, and postoperative care to guard against the associated thrombotic consequences.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
Externí odkaz: