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Microsurgery and the Hypercoagulable State: A Hematologist's Perspective
Christopher J Pannucci1, Stephen J Kovach, Adam Cuker
1Salt Lake City, Utah; and Philadelphia, Pa. From the Division of Plastic Surgery, University of Utah; and the Divisions of Plastic Surgery and Hematology/Oncology, University of Pennsylvania.
Hypercoagulability can pose a significant problem in microsurgical reconstruction. Here, the authors provide a comprehensive review of macrovascular and microvascular clotting phenomena from the unique viewpoint of two microsurgeons and a hematologist. The authors review the literature surrounding prevention of microvascular clots and provide an extensive discussion of hereditary thrombophilia. The authors also make explicit recommendations regarding the utility of thrombophilia testing and preoperative and perioperative management strategies for patients with hypercoagulability.
Hypercoagulability can pose a significant problem in microsurgical reconstruction. Here, the authors provide a comprehensive review of macrovascular and microvascular clotting phenomena from the unique viewpoint of two microsurgeons and a hematologist. The authors review the literature surrounding prevention of microvascular clots and provide an extensive discussion of hereditary thrombophilia. The authors also make explicit recommendations regarding the utility of thrombophilia testing and preoperative and perioperative management strategies for patients with hypercoagulability.
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