APPLICATIONS OF VISCOELASTIC TESTING IN MICROSURGERY: A SYSTEMIC REVIEW AND META-ANALYSIS.

Area of Science:

• Coagulation science
• Hemostasis
• Surgical monitoring

Background:

• Viscoelastic testing (TEG/ROTEM) provides in-vitro whole blood analysis of coagulation.
• Conventional clotting tests (CCTs) do not fully replicate native hemostasis.
• TEG/ROTEM are increasingly adopted in various surgical fields.

Approach:

• Systematic review and meta-analysis of TEG/ROTEM applications in microsurgery.
• Evaluation of evidence supporting current uses.
• Exploration of future potential in microsurgical monitoring.

Key Points:

• TEG/ROTEM assess interactions between platelets, red blood cells, and clotting factors.
• These tests can identify real-time risks of bleeding or thrombosis.
• Microsurgery patients may benefit from TEG/ROTEM for flap failure risk assessment.

Conclusions:

• Evidence for TEG/ROTEM in microsurgery is reviewed.
• Potential benefits for monitoring microsurgical patients are highlighted.
• Future directions for TEG/ROTEM in microsurgery are discussed.