J Reconstr Microsurg 2025; 41(07): 606-613
DOI: 10.1055/a-2460-4761
Original Article

Antithrombotic Agents after Free Tissue Transfer in the Pediatric and Adolescent Population

1   Department of Plastic and Hand Surgery, University of Freiburg Medical Center, Medical Faculty of the University of Freiburg; Freiburg, Germany
,
1   Department of Plastic and Hand Surgery, University of Freiburg Medical Center, Medical Faculty of the University of Freiburg; Freiburg, Germany
,
Steffen U. Eisenhardt
1   Department of Plastic and Hand Surgery, University of Freiburg Medical Center, Medical Faculty of the University of Freiburg; Freiburg, Germany
› Author Affiliations
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Abstract

Background

Even for the experienced microsurgeon, free tissue transfer in pediatric patients is challenging, and large patient series remain scarce in the literature. Moreover, the added value of antithrombotic agents in pediatric free tissue transfer remains unclear.

Methods

We conducted a retrospective outcome analysis of pediatric free tissue transfer with respect to postoperative antithrombotic treatment at our tertiary academic center. All patients aged 0 to 18 years who underwent free tissue transfer from 1998 to 2022 were included in the study.

Results

Seventy patients received 73 free tissue transfers. The most common indications were facial paralysis, trauma, and tumor (49.3, 21.9, and 20.5%, respectively). The most common recipient sites were the head and neck (56.1%) and lower extremity (32.8%). We observed a flap revision rate of 12.5% of the cases and one flap loss (1.4%). A total of 58.9% of the population received postoperative antithrombotic agents. The rate of flap revision surgery was similar (11.6 and 10.0%, respectively), with and without antithrombotic treatment (p > 0.05). There were no major bleeding complications or deep vein thrombosis.

Conclusion

The antithrombotic treatment did not seem to affect the flap revision rate or the bleeding complications in our cohort. Hence, the data do not support the routine administration of antithrombotic treatment in pediatric free flap reconstruction. However, these findings should be solidified in prospective randomized trials.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.


Patient Consent Statement

Informed consent for the publication of photographs was obtained from the patients shown in this study.




Publication History

Received: 11 July 2024

Accepted: 16 October 2024

Accepted Manuscript online:
04 November 2024

Article published online:
29 November 2024

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