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Related Experiment Video

Updated: Jun 21, 2026

A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery
08:05

A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery

Published on: November 8, 2019

Microvascular free flap failure caused by unrecognized hypercoagulability.

Steven P Davison1, Craig M Kessler, Ali Al-Attar

  • 1Washington, D.C. From the Department of Plastic Surgery and the Division of Coagulation, Georgetown University Hospital.

Plastic and Reconstructive Surgery
|August 1, 2009
PubMed
Summary
This summary is machine-generated.

Undiagnosed hypercoagulability can cause microvascular free flap failure despite technical advances. Early diagnosis and management of these clotting disorders are crucial for successful reconstruction.

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Last Updated: Jun 21, 2026

A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery
08:05

A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery

Published on: November 8, 2019

Area of Science:

  • Plastic Surgery
  • Vascular Surgery
  • Hematology

Background:

  • Microvascular free flap techniques have advanced significantly, reducing failure rates to below 3% in high-volume centers.
  • Despite improvements, some free flap failures may stem from undiagnosed patient-specific factors.
  • Patient selection and surgical technique are critical, but other elements can influence outcomes.

Observation:

  • This article presents four patients experiencing major microvascular free flap complications.
  • These patients were later diagnosed with multiple risk factors for hypercoagulability and biochemical abnormalities.
  • Hematologic consultation and laboratory investigations identified these underlying issues.

Findings:

  • Previously undiagnosed hypercoagulability was identified in four patients with major free flap microvascular complications.
  • Biochemical abnormalities contributing to hypercoagulability were revealed through laboratory testing.
  • These clotting disorders represent a potential cause of free flap failure independent of surgical technique or patient selection.

Implications:

  • Undiagnosed hypercoagulability is a critical factor in certain microvascular free flap failures.
  • Prompt diagnosis and management of hypercoagulability are essential for patient care.
  • Initiating deep venous thromboembolism prophylaxis is a key clinical component for at-risk patients.