Oral antithrombotic treatment and postoperative thrombotic complications after head and neck reconstruction using...

Recently, oral antithrombotic treatment has been used to treat cerebral infarction, myocardial infarction, and vascular diseases, and these patients may have vascular damage. However, we know of no reports about the development of postoperative complications in patients who have free tissue transfers with preoperative antithrombotic prophylaxis. We retrospectively reviewed 150 patients who had had immediate reconstruction with free tissue transfer after excision of cancers in the head and neck between April 2001 and March 2006. We found nine patients who had been given preoperative antithrombotic prophylaxis: four of the nine had thrombotic complications (myocardial infarction (n = 1), cerebral infarction (n = 1), and necrosis of the flap caused by thrombus at an anastomotic site (n = 2)), whereas 4 of the remaining 141 patients had thrombotic complications, all of which were flap necrosis from thrombotic occlusion of an anastomotic site. Patients given antithrombotic prophylaxis may easily develop a thrombus, and our findings suggest that management of the coagulation system is necessary.