Microsurgery最新文献

{"title":"Vascularized Femoral Myo-Periosteal Graft for Congenital Pseudarthrosis of the Tibia: A Case Report","authors":"Francisco Soldado,&nbsp;Danilo Rivas-Nicolls,&nbsp;Juliana Rojas-Neira,&nbsp;Juan J. Sevilla-Tirado,&nbsp;Trong-Quynh Nguyen,&nbsp;Jorge Knorr","doi":"10.1002/micr.31218","DOIUrl":"10.1002/micr.31218","url":null,"abstract":"<div>\u0000 \u0000 <p>Pure vascularized periosteal transplants have been shown to be extremely effective at achieving rapid bone healing in children with biologically complex non-union. Free tibial and fibular periosteal transplants are generally indicated when large periosteal flaps are necessary. We report using a vascularized femoral myo-periosteal graft (VFMPG) to treat distal tibial osteotomy non-union in a six-year-old boy with congenital pseudarthrosis of the tibia. The graft consisted of a 9 cm myo-periosteal flap (after 50% of elastic retraction) that incorporated the vastus intermedius muscle and diaphyseal femoral periosteum nourished by the descending branch of the lateral circumflex femoral vessels. Plantaris medialis was used as a recipient vessel. Healing occurred 10 weeks after surgery. The patient resumed gait and sports activity without orthosis. No donor or recipient site complications occurred 17 months after surgery. Employing a VFMPG might be an alternative to other free or large vascularized periosteal flaps currently in use for complex pediatric non-unions.</p>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of ECMO and Free-Fillet-Leg Flap for Complex Pelvic Reconstruction: A Case Report","authors":"Emanuele Cigna,&nbsp;Alberto Bolletta,&nbsp;Mirco Pozzi,&nbsp;Michela Schettino,&nbsp;Olimpia Mani,&nbsp;Lorenzo Andreani,&nbsp;Ugo Boggi,&nbsp;Rodolfo Capanna","doi":"10.1002/micr.31234","DOIUrl":"10.1002/micr.31234","url":null,"abstract":"<div>\u0000 \u0000 <p>Advanced sarcoma treatment in complex anatomical regions such as the pelvis poses significant surgical challenges. This report details a case involving a 35-year-old man with recurrent osteosarcoma of the left hemipelvis, who underwent a 16 h surgery for hemipelvectomy and reconstruction using a free tibia and fibula fillet leg flap. The procedure, necessitated by an infected, exposed iliac prosthesis, utilized extracorporeal membrane oxygenation (ECMO) for 8 h to maintain flap viability. The flap, incorporating tibia, fibula, and associated musculature was successfully inset and anastomosed to the left common iliac artery and vein, with additional venous anastomosis to the right iliac vein. Despite postoperative challenges such as venous stasis and intestinal ischemia, necessitating further surgical interventions, the patient achieved mobility with a walker at 3 months post-surgery, with stable conditions observed during a 2 years follow-up. ECMO enabled successful preservation and integration of the free fillet leg flap, demonstrating its potential in complex reconstructive surgeries. Specifically, ECMO may extend free flap viability in complex cases, offering new possibilities for challenging oncological and reconstructive surgeries.</p>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Penile and Donor Site Sensory Outcomes After Innervated Radial Forearm Free Flap Phalloplasty: A Pilot Prospective Study","authors":"Sophia Hu,&nbsp;Norah Oles,&nbsp;Erik Reiche,&nbsp;Raphael Kim,&nbsp;Wilmina Landford,&nbsp;Lauren Eisenbeis,&nbsp;Melissa Noyes,&nbsp;Calvin R. Schuster,&nbsp;Michael Parisi,&nbsp;Siti Rahmayanti,&nbsp;Vance Soares,&nbsp;A. Lee Dellon,&nbsp;Devin Coon","doi":"10.1002/micr.31228","DOIUrl":"10.1002/micr.31228","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Radial forearm free flap phalloplasty (RFFF) is a set of complex reconstructive procedures aimed at creating an aesthetic and functional penis in transgender patients. Sensory recovery in the neophallus and donor site is crucial for optimizing outcomes, but the few prior studies that exist assess neophallus sensation at limited locations and time points. The purpose of this study was to prospectively quantify sensory outcomes in the neophallus and donor site following RFFF phalloplasty.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Sensation testing occurred prospectively over February 2019–January 2021 on Stage 1 RFFF phalloplasty patients using the Pressure Specified Sensory Device (PSSD). On the neophallus, one-point discrimination (1PS) pressure threshold and lengthwise sensory recovery were measured at six circumferential locations proximally to distally. On the donor site, 1PS was measured at three locations on the donor hand.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Nineteen patients were included (average age 34.0 years old, range 18–53 years). Among patients that received neophallus testing (&lt;i&gt;n&lt;/i&gt; = 13), eight had at least two follow-up appointments. Six of these patients had sensation as of their most recent measurement (75.0%), with an average of 73 days to regain sensation. There was a significantly greater proportion of patients with sensation at the right ventral (80.0% after 3 months vs. 11.1%–60.0% before 3 months, &lt;i&gt;p&lt;/i&gt; = 0.024) and right lateral (100.0% after 3 months vs. 11.1%–60.0% before 3 months, &lt;i&gt;p&lt;/i&gt; = 0.004) aspects of the neophallus over time. Pressure required to elicit sensation decreased by 18.0% from 1 week–1 month postoperatively to 3–7.7 months postoperatively in the right ventral neophallus (96.2 g/mm&lt;sup&gt;2&lt;/sup&gt; ± 11.3 g/mm&lt;sup&gt;2&lt;/sup&gt; to 56.6 ± 39.9 g/mm&lt;sup&gt;2&lt;/sup&gt;, &lt;i&gt;p&lt;/i&gt; = 0.037). Among patients that received donor site testing (&lt;i&gt;n&lt;/i&gt; = 11), mixed effects regression analysis with random intercepts demonstrated significant changes in the thumb (3.4 g/mm&lt;sup&gt;2&lt;/sup&gt; ± 1.4 g/mm&lt;sup&gt;2&lt;/sup&gt;, &lt;i&gt;p&lt;/i&gt; &lt; 0.05) and webspace (13.5 g/mm&lt;sup&gt;2&lt;/sup&gt; ± 4.9 g/mm&lt;sup&gt;2&lt;/sup&gt;, &lt;i&gt;p&lt;/i&gt; &lt; 0.01) that returned to baseline at 3 months postoperatively (1.7 g/mm&lt;sup&gt;2&lt;/sup&gt; ± 1.0 g/mm&lt;sup&gt;2&lt;/sup&gt;, &lt;i&gt;p&lt;/i&gt; &gt; 0.05, and 2.3 g/mm&lt;sup&gt;2&lt;/sup&gt; ± 4.0 g/mm&lt;sup&gt;2&lt;/sup&gt;, &lt;i&gt;p&lt;/i&gt; &gt; 0.05, respectively).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This pilot study demonstrates that quantitative sensory testing can be used to monitor post-phalloplasty sensory changes. Recovery was significantly associated with contralateral (i.e, right side in a left","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Increased Body Mass Index on Patient Outcomes and Complications in Microsurgical Lower Extremity Reconstruction","authors":"Eloise W. Stanton,&nbsp;Artur Manasyan,&nbsp;Elizabeth Boudiab,&nbsp;Joseph N. Carey,&nbsp;David A. Daar","doi":"10.1002/micr.31231","DOIUrl":"10.1002/micr.31231","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Elevated body mass index (BMI) is a known perioperative risk factor for complications such as delayed wound healing and infection. However, there is a gap in understanding how elevated BMI impacts outcomes after posttraumatic lower extremity (LE) microvascular reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review was performed at a level 1 trauma center between 2007 and 2022 of patients who underwent posttraumatic microvascular LE reconstruction. Demographics, flap/wound details, complications, and outcomes were recorded. Patients were stratified into BMI Center for Disease Control categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 398 patients were included with an average BMI of 28.2 ± 5.8. Nearly half (45%) of LE defects were located in the distal third of the leg, 27.5% in the middle third, and 34.4% in the proximal third. Most reconstructions utilized muscle-containing flaps (74.4%) compared with fasciocutaneous flaps (16.8%). Surgical approaches included free flaps (47.6%) and local flaps (52.5%). Class III obese patients were significantly more likely to be nonambulatory than nonobese patients (OR: 4.10, 95% CI 1.10–15.2, <i>p</i> = 0.035). At final follow-up, 30.1% of patients with Class III obesity were ambulatory, requiring either wheelchairs (42.3%) or assistance devices (26.9%). There were no significant differences in complication rates based on obesity status (0.704). The average follow-up time for the entire cohort was 5.8 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BMI is critical for patient care and surgical decision-making in LE reconstruction. Further research is warranted to optimize outcomes for higher BMI patients, thereby potentially reducing the burden of postoperative complications and enhancing overall patient recovery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Free Superficial Circumflex Iliac Artery Perforator Flap for Reconstruction of Traumatic Thumb Soft Tissue Defect in an 18-Year-Old Male Patient","authors":"Hsu-Tang Cheng","doi":"10.1002/micr.31225","DOIUrl":"10.1002/micr.31225","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Free Internal Mammary Artery Perforator Flap Harvested With Minimally Invasive Approach for Facial Reconstruction: Report of Two Cases","authors":"Yun Choi,&nbsp;Kyeong-Tae Lee","doi":"10.1002/micr.31233","DOIUrl":"10.1002/micr.31233","url":null,"abstract":"<div>\u0000 \u0000 <p>The internal mammary artery perforator (IMAP) flap has been widely used for chest wall and neck reconstruction. The color of its skin paddle closely resembles that of facial skin, making it attractive for facial reconstruction. However, there has been insufficient investigations reporting the use of free IMAP flap. Furthermore, even in such studies, somewhat invasive procedures, including rib cartilage resection, were employed to ensure sufficient pedicle length, potentially increasing donor morbidity. Our report presents two cases of successful facial defect reconstruction using a free IMAP flap harvested with minimal donor site damage, showing its feasibility. In the first case, a 48-year-old male underwent wide excision for a malignant melanoma on his right cheek, resulting in a 4 × 4.5 cm full-thickness defect. A free IMAP flap with a 2.5 cm pedicle, was harvested without rib cartilage resection, preserving IMA main trunk, and transferred with anastomosed to the angular vessels within the defect. The second patient presented with a 4.5 × 3.5 cm basal cell carcinoma on the left cheek, necessitating wide excision and leaving a 6 × 5 cm defect. A free IMAP flap was harvested with the same approach and successfully reconstructed the defect with connected to the superficial temporal vessels using vascular bridge. Both patients were discharged complication-free, with no recurrence during 24 and 15 months of follow-up, respectively. They were highly satisfied with the final skin color and texture outcomes. Harvesting a free IMAP flap while minimizing donor morbidity may offer an attractive option for facial reconstruction.</p>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of a Complex, Recurrent Case of Medial Thigh Sarcoma With Pedicled Deep Inferior Epigastric Artery Perforator (DIEP) Lymphatic Flow-Through (LyFT) Flap and Secondary Anterolateral Thigh (ALT) Free Flap With Innervated Vastus Lateralis Anastomosed to Synthetic Artery Graft: A Case Report","authors":"Federica Martini,&nbsp;Matteo Meroni,&nbsp;Mario F. Scaglioni","doi":"10.1002/micr.31224","DOIUrl":"10.1002/micr.31224","url":null,"abstract":"<div>\u0000 \u0000 <p>Soft-tissue sarcomas (STS) are rare solid tumors of mesenchymal cell origin and account for only 1% of adult malignancies. They tend to occur most commonly in the lower extremities. Reconstruction after sarcoma resection can be challenging, especially when important structures are involved and recurrences occur. Additionally, more attention is now being paid to reconstructing the lymphatic system to prevent lymphatic complications. In this case report, we presented the management of recurrent medial thigh sarcoma that necessitated multiple challenging reconstructions to provide valuable insights for lectures on similar cases. A 50-year-old male patient was diagnosed with an undifferentiated pleomorphic cell sarcoma (UPS) of the anteromedial thigh. After preoperative radiotherapy, a mass of 23 × 15 cm was removed, and reconstruction with a pedicled deep inferior epigastric artery perforator (p-DIEP) flap-based lymphatic flow through (LyFT) was performed. Six months later, the patient developed the first local recurrence with the presence of a distant metastasis. Following the tumor resection, the medial part of the DIEP flap was de-epithelized and buried in the defect for dead space obliteration. Another local recurrence arose 7 months after the second surgery. Therefore, a major debulking surgery involving the femoral neurovascular bundle was performed. The femoral artery was reconstructed with a synthetic graft, and the femoral vein with the great saphenous vein harvested from the contralateral thigh. A composite myocutaneous neurotized anterolateral thigh (ALT) flap from the contralateral thigh was used to obliterate the defect and restore the loss of function of the quadriceps femoris. Two lymphaticovenular anastomoses (LVAs) were performed at the ankle to reduce the risk of lymphatic sequelae. This case report highlights the importance of integrating various techniques to create a tailored approach that effectively addresses complex surgical requirements to avoid limb amputation and maintain functionality.</p>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142109379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Your Hands as a Visual Aide to Teach and Remember the Order of Suture Placement in Arterial Micro-Anastomosis","authors":"Elena Kakouri,&nbsp;Anna A. K. Khoo,&nbsp;Guido Köhler,&nbsp;Richard M. Haywood","doi":"10.1002/micr.31223","DOIUrl":"https://doi.org/10.1002/micr.31223","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142100164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interposition of Free Vascularized Fascia Into the Trapezial Resection Cavity for the Surgical Treatment of Trapeziometacarpal Osteoarthritis","authors":"Simo Mattila,&nbsp;Ville Haapamäki,&nbsp;Eero Waris","doi":"10.1002/micr.31221","DOIUrl":"https://doi.org/10.1002/micr.31221","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Backround</h3>\u0000 \u0000 <p>Trapeziometacarpal osteoarthritis has been treated with interposition of autologous fascia into the trapezial resection cavity to prevent scaphometacarpal impingement with suboptimal results. Autologous fascia may undergo necrosis and gradual shrinkage due to avascularity. We propose vascularization of the interposed fascia using microvascular techniques as a new alternative to achieve a durable graft with sufficient soft tissue volume.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>In this retrospective study, 11 surgeries for 8 patients (6 women, 2 men) (5 primary and 6 revision cases) were performed using vascularized fascial grafts from the anterolateral thigh for interposition in the trapezial resection cavity with microvascular anastomosis for revascularization. Subjective assessment included the short version of the Quick Disabilities of the Hand, Shoulder and Arm and patient related hand wrist evaluation scores. Objective assessment included strength and range of motion measurements. Radiographs were obtained preoperatively and at each follow-up visit. An MRI was done at a mean of 19 months postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The size of the harvested fascial grafts was 2 × 2–3 cm with a thickness of 1.5–2 cm. There were no postoperative complications apart from one seroma in the graft harvest site. The mean clinical and radiologic follow-up was 2 years and 8 months. The procedure provided pain relief PRWHE pain 32 (SD 13)—9 (SD 12), <i>p</i> &lt; 0.0001, increased tip pinch strength 4 kg (SD3)—6 kg (SD2), <i>p</i> &lt; 0.05, and improved overall function PRWHE 60 (SD28)—16 (SD21), <i>p</i> &lt; 0.0001 and QuickDash 50 (SD21)—13 (SD17), <i>p</i> &lt; 0.0001. Radiographs demonstrated maintenance of the scaphometacarpal space, while MRI scans showed the presence of mildly edematous interposed tissue within the resection cavity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although technically demanding, vascularized fascia presents an attractive alternative for the treatment of trapeziometacarpal osteoarthritis. It may be particularly advantageous in complex cases requiring revision surgery and in young patients with high functional demands.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/micr.31221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142100280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thrombotic Consequences of COVID-19 Infection on Microsurgical Reconstruction","authors":"Sabrina H. Han,&nbsp;Kyle Ockerman,&nbsp;Matthew Kirchmier,&nbsp;Markos Mardourian,&nbsp;Jaimie Bryan,&nbsp;Elizabeth Cox,&nbsp;Harvey Chim,&nbsp;Lisa Spiguel,&nbsp;Arash Momeni,&nbsp;Sarah Sorice-Virk","doi":"10.1002/micr.31219","DOIUrl":"https://doi.org/10.1002/micr.31219","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Evidence has shown increased morbidity and mortality for patients with COVID-19 infection within 7 weeks of surgery. However, no studies have specifically investigated the effects of COVID-19 in microsurgical outcomes. This study evaluated thrombotic and overall complications after free tissue transfer for a variety of indications in patients with and without previous COVID-19 infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was performed in adult patients with or without a history of COVID-19 infection who underwent microsurgical reconstruction between 2017 and 2022. Patients with a history of COVID-19 infection were matched to controls based on age, gender, race, body mass index, history of diabetes, coronary artery disease, hypertension, Caprini score, tobacco use, and flap indication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 2017 to 2022, 35 patients had a documented history of COVID-19. Matched case analysis determined a 4.8 times increased odds ratio of postoperative complications in the COVID-19 group compared with controls (<i>p</i> = 0.002). Significantly, more patients with COVID-19 experienced total or partial flap loss and anastomotic issues (COVID-19: 7/35, Control: 0/35; <i>p</i> &lt; 0.001). There was no significant difference in incidence of VTE (COVID-19: 1/35, Control: 0/35; <i>p</i> = 0.493). Of note, 62.9% of the COVID-19 group were discharged on anticoagulants (versus 14.3% in the control group [<i>p</i> &lt; 0.001]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>COVID-19 has dire, long-lasting effects on virtually every organ system, chief among them, the microcirculation. Further studies are needed to fully determine the extent and influence of COVID-19 on complex procedures such as free tissue transfer and how to optimize the screening, workup, and postoperative care to guard against the associated thrombotic consequences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142100081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}