Abstract:
BACKGROUND: Due to limited evidence, it is unclear whether postoperative anticoagulation therapy may lead to higher success rates for microvascular free-flap surgery in the head and neck. This review evaluated whether postoperative anticoagulation therapy can lead to a better result in head and neck reconstruction. METHODS: PubMed, Embase, and the Cochrane Library were used to search for articles on the efficacy of postoperative antithrombotic therapy in free-flap transfer during head and neck reconstruction without language restrictions in February of 2017. A random-effects model was used to estimate the relative risk ratio (RR) with 95% confidence intervals (CIs). The measured outcomes were flap loss, thromboembolic events, and hematoma formation. RESULTS: A total of 2,048 free-flap surgery procedures in the head and neck were analyzed. There was no significant difference in the occurrence of flap loss and thromboembolic events in the anticoagulation group compared with the nonanticoagulation group (RR = 1.25, 95% CI = 0.85-1.81, p = 0.26; and RR = 1.05, 95% CI = 0.74-1.48, p = 0.79, respectively). The risk of hematoma was twice as high in the anticoagulation group than the nonanticoagulation group, which was statistically significant (RR = 2.02, 95% CI = 1.08-3.76, p = 0.03). CONCLUSION: The findings from our meta-analysis indicate that postoperative anticoagulation therapy barely decreases the risks of flap loss and thromboembolic events in free-flap surgery in the head and neck. However, it may significantly increase the risk of hematoma formation. Considering the limitations of this meta-analysis, additional high-quality, multicenter, prospective, randomized controlled studies are needed to confirm these findings.
journal_name
J Reconstr Microsurgjournal_title
Journal of reconstructive microsurgeryauthors
Liu J,Shi Q,Yang S,Liu B,Guo B,Xu Jdoi
10.1055/s-0037-1606346subject
Has Abstractpub_date
2018-02-01 00:00:00pages
87-94issue
2eissn
0743-684Xissn
1098-8947journal_volume
34pub_type
杂志文章,meta分析,评审abstract::Background Although flap transfer is a popular reconstructive procedure with a high success rate, it is associated with a high complication rate and low salvage rate. During the past decade, negative-pressure wound therapy (NPWT) has been increasingly applied to facilitate flap transfer and salvage flaps threatened by...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1599076
更新日期:2017-06-01 00:00:00
abstract::During the last seven years, 17 patients underwent microsurgical reconstruction of 14 hepatic and four superior mesenteric arterial systems following extended pancreatectomy or hepatectomy, and in living-related liver transplantations (LRLT). All microvascular anastomoses in this series were performed using a back wal...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000109
更新日期:1999-07-01 00:00:00
abstract::Nerve decompression surgery for leprosy neuritis has a long history and large literature. New understanding of the high frequency of spontaneous recovery from nerve function impairment requires re-evaluation of the value of decompression in acute nerve dysfunction with strong evidence-based protocols. Several reports ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0030-1248237
更新日期:2010-05-01 00:00:00
abstract::Patient safety is defined as freedom from accidental or preventable harm produced by medical care. The identification of patient- and procedure-related risk factors enables the surgical team to carry out prophylactic measures to reduce the rate of complications and adverse events.The purpose of this review is to ident...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1693142
更新日期:2019-11-01 00:00:00
abstract::The effect of slow-release basic fibroblast growth factor (bFGF) on ischemia-reperfusion injury was examined using an island skin flap model in rats. Paired rectangular island skin flaps were elevated on the dorsum of 30 Fischer rats. The flaps were subjected to 6 hours of ischemia. Before reperfusion the flaps were i...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0033-1343830
更新日期:2013-06-01 00:00:00
abstract::Background To date, only a few reports have been published on idiopathic lymphedema, and most of these are case reports. In this time, we performed a retrospective review of idiopathic lymphedema patients. Methods Forty patients presented with idiopathic lymphedema that was unrelated to surgery, injury, and medical co...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0036-1586257
更新日期:2017-01-01 00:00:00
abstract::Regardless of its type, the repair of a peripheral nerve must ideally permit early motion of the affected limb and resist disruption by the tensile forces generated throughout the healing process and regeneration. A comparative study of the mechanical resistance of the repair of the sciatic nerve with biological glue ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2008-1080535
更新日期:2008-07-01 00:00:00
abstract::Successful reconstruction of diabetic ulcers using free flap surgery can prevent further amputation and promote limb salvage to maintain normal gait of the patient and increase the quality of life after surgery. To minimize the postoperative complication and days of stay in hospital, surgeons should thoroughly investi...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0040-1714431
更新日期:2021-01-01 00:00:00
abstract::The ultrastructure of the early regenerative response in an end-to-side neurorrhaphy rat model was studied using transmission electron microscopy. The ipsilateral saphenous nerve was grafted to the sciatic nerve under the following conditions: Group 1, the epineurium and perineurium of the sciatic nerve remained intac...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2000-7339
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:This is a systematic review for evaluating the evidence for functional outcomes after decellularized nerve use in clinical setting. Decellularized nerves are allografts whose antigenic components have been removed, leaving only a scaffold that promotes the full regeneration of axons. METHODS:Literature rese...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1558463
更新日期:2015-11-01 00:00:00
abstract::Perforator flaps based on either musculocutaneous or septocutaneous perforators are no longer a curiosity, but rather in the past decade have become "workhorse" soft tissue alternatives. Yet a keener understanding of their anatomy abetted by sophisticated imaging techniques has revealed other deep fascia perforators w...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1315777
更新日期:2012-10-01 00:00:00
abstract::In a comparative study, it was demonstrated that sutureless, laser-welded, end-to-end anastomoses in the rat femoral artery and vein are feasible, using either CO2 or Nd:YAG laser. Conventional microsurgical suture anastomoses served as the controls. Patency rates in experimental animals and controls were equal (96 to...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006647
更新日期:1993-05-01 00:00:00
abstract::A model of chronic entrapment neuropathy in the rabbit sciatic nerve was developed to try to elucidate the pathogenesis of chronic nerve entrapment. A non-compressive Silastic cuff was wrapped around the nerve at the mid-thigh level in eight rabbits. A sham operation that only elevated the sciatic nerve was performed ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000070
更新日期:1999-01-01 00:00:00
abstract::The lateral forearm flap is being increasingly used for covering minor-to-moderate-sized defects for which soft and thin skin is required. Within the framework of an anatomic study carried out on 28 cadaveric arms, the authors investigated the principal artery that supplies blood to this flap namely, the posterior rad...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2000-7537
更新日期:2000-01-01 00:00:00
abstract::A free-flap model in rats is presented, that consists of gracilis and semitendinosus muscles pedicled on the femoral vessels, in continuation with deep femoral and saphenous vessels. This flap was transferred to the contralateral side in 40 rats and yielded a 95 percent survival rate. The weight of the flaps averaged ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000175
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:While many potential donor sites have been described for fascial (fascia-only) flaps, a fascial flap harvested from the anterolateral thigh (ALT) donor site has not gained popularity, likely because of concerns regarding inadequate perfusion of the deep fascia. However, recent clinical experience demonstrate...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0033-1361843
更新日期:2014-11-01 00:00:00
abstract::The authors performed anastomoses of small vessels with the Nd-YAG laser, comparing these with conventional suture anastomoses. Some arteries were sutured with 10-0 nylon with about eight suture sites, and others were held by stay sutures at three points with laser irradiation performed between them. Two surgeons perf...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2000-8399
更新日期:2000-10-01 00:00:00
abstract::Vascularized periosteal graft is a frequently applied flap model for bone prefabrication studies due to its inhabitance of osteoprogenitor cells and osteoinductive potential. Various bones such as rib and fibula are reported as a potential source for the harvest of the periosteal flap in experimental studies on higher...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0031-1301068
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND: There is an increasing trend toward bilateral breast reconstruction. Using the National Surgical Quality Improvement Program (NSQIP) database, we sought to understand the association between unilateral and bilateral free flap breast reconstruction and operative time and flap failure. METHODS: We selected a...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0038-1627445
更新日期:2018-07-01 00:00:00
abstract::Experiments have been performed using CO2 laser-assisted microvascular anastomoses, and they demonstrated the following features, in comparison with conventional anastomoses: ease in technique; less time consumption; less tissue inflammation; early wound healing; equivalency of patency rate and inner pressure toleranc...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006783
更新日期:1991-07-01 00:00:00
abstract::Findings reported in the literature on the sensation provided by intraorally applied innervated vs. non-innervated radial forearm free flaps differ. In an effort to understand these differences in sensory recovery, the authors carried out sensory evaluations in 12 patients who had undergone radial forearm free flaps. ...
journal_title:Journal of reconstructive microsurgery
pub_type: 临床试验,杂志文章
doi:10.1055/s-2000-7549
更新日期:2000-04-01 00:00:00
abstract::The enhancement of blood flow in experimental skin flaps following postischemic perfusion washout was investigated in rats. Unilateral island skin flaps based on the superficial epigastric vessels were raised and subjected to 6 hr of primary ischemia. Group 1 was designated as a control and did not undergo postischemi...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006753
更新日期:1993-11-01 00:00:00
abstract::Shoulder pathology and its diagnosis must be considered in evaluation of the patient suspected of having thoracic outlet syndrome (TOS). Overlooking usually treatable conditions in the shoulder may lead to unfavorable results, if treatment is directed, instead, to neurolysis of the brachial plexus or first rib resecti...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006714
更新日期:1992-07-01 00:00:00
abstract::This study investigated the intact nerve bridge technique for overcoming peripheral nerve gap defects in a rabbit model. To create the intact nerve bridge, a 1-cm segment of the peroneal nerve is resected leaving a gap defect. The proximal and distal peroneal nerve stumps are sutured 1 cm apart, in an end-to-side fash...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2005-869827
更新日期:2005-04-01 00:00:00
abstract::Composite tissue allograft (CTA) transplantation, such as the clinical face and hand transplants, has now been performed in multiple centers across the world. The transplants have successfully treated complex injuries that have either failed conventional approaches or where autologous reconstruction could not restore ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1285988
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND: During reconstructive surgery, anterolateral thigh (ALT) flap harvest is challenging due to variation and uncertainty in perforator distribution. We performed a pilot study to identify the predictive value of catheter-based computed tomography angiography (C-CTA) and traditional CTA (T-CTA) in ALT perforato...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0038-1672129
更新日期:2019-03-01 00:00:00
abstract::Injury to the dorsal sensory nerve of the penis following penile prosthesis insertion is extremely rare. The authors report on a patient with insensitivity involving the right penile shaft and glans secondary to entrapment and fibrosis of the dorsal cutaneous nerve of the penis, following penile prosthesis insertion. ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006898
更新日期:1998-01-01 00:00:00
abstract::Aberrant reinnervation of target organs caused by misdirected axonal growth at the repair site is a major reason for the poor functional outcome usually seen after peripheral nerve transection and repair. This study investigates whether the criss-crossing of regenerating rat sciatic nerve axons between tibial and pero...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2004-861524
更新日期:2004-11-01 00:00:00
abstract::Composite tissue transplantation has emerged as a viable alternative to prosthetics and complex reconstructive surgery. Thus far it is reserved for cases which cannot be effectively reconstructed and where it offers some benefits over prostheses. It has been used in the upper extremity with encouraging results and, mo...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2006-939928
更新日期:2006-05-01 00:00:00
abstract::This study examined the use of freeze-thawed muscle as a nerve graft material in Sprague-Dawley rats. In Group 1 (n = 4), the sciatic nerve was isolated and the incision immediately closed. In Group 2 (n = 4), a 5-mm segment of the nerve was removed and immediately replaced. In Group 3 (n = 50), a 5-mm segment of nerv...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006580
更新日期:1994-05-01 00:00:00