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Related Concept Videos

Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

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The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
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Updated: Oct 1, 2025

New Thrombectomy Technique for Total Portal Vein Thrombosis in Liver Transplantation
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Thromboelastography in Microsurgical Reconstruction: A Systematic Review.

M Thakkar1, A Rose2, B Bednarz3

  • 1Department of Plastic and Reconstructive Surgery, St Mary's Hospital, Praed Street, London, W2 1NY.

JPRAS Open
|March 4, 2022
PubMed
Summary
This summary is machine-generated.

Thromboelastography (TEG) may help predict thrombotic complications in free flap surgery. Pre-operative TEG and a fibrinogen to platelet ratio of ≥42 show potential for identifying at-risk patients, but more research is needed.

Keywords:
Free flapsFree tissue transferMicrosurgical reconstructionROTEMTEGThromboelastographyThromboelastometry

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Area of Science:

  • Surgical Oncology
  • Vascular Surgery
  • Hematology

Background:

  • Microsurgical free flap reconstruction is crucial for tissue reconstruction.
  • Thrombotic complications remain a significant cause of free flap failure.
  • Predictive tools for thrombotic events are needed to improve patient outcomes.

Purpose of the Study:

  • To review studies utilizing thromboelastography (TEG) or rotational thromboelastometry (ROTEM) in microsurgical free flap reconstruction.
  • To analyze the utility of TEG/ROTEM in predicting and identifying thrombotic complications.
  • To assess the impact of TEG on patient morbidity and surgical outcomes.

Main Methods:

  • A systematic literature search was conducted on the MEDLINE database.
  • Keywords included "thromboelastogram", "TEG", "thromboelastography", "free flaps", and "free tissue transfer".
  • Eight studies were retrieved, with seven meeting inclusion criteria, encompassing 528 patients and 600 free flaps.

Main Results:

  • A combined incidence of 10.3% arterial and venous thromboses and 5.2% flap failure rate was reported.
  • Sixty-seven percent of studies supported TEG as a statistically significant predictive tool for thromboses.
  • Low-quality evidence suggests pre-operative TEG and a fibrinogen to platelet ratio ≥42 can identify at-risk patients.

Conclusions:

  • TEG shows promise as a pre-operative screening tool in free flap surgery.
  • It can aid in detecting coagulation abnormalities, guiding transfusions, and targeting anticoagulation.
  • Higher quality prospective trials are required to validate TEG's predictive value and reduce patient morbidity.