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Semin Plast Surg 2023; 37(01): 057-072
DOI: 10.1055/s-0042-1760381
Review Article

Chemoprophylaxis and Management of Venous Thromboembolism in Microvascular Surgery

Fatemeh Mirzamohammadi
1   Wright State University Plastic Surgery Residency Program, Wright State University Boonshoft School of Medicine, Dayton, Ohio
,
Ogonna N. Nnamani Silva
2   Harvard Plastic Surgery Residency Program, Harvard Medical School, Boston, Massachusetts
,
Rebecca K. Leaf
3   Division of Hematology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
,
Kyle R. Eberlin
4   Division of Plastic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
,
Ian L. Valerio
4   Division of Plastic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
› Author Affiliations
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Abstract

This review aims to highlight the common pharmacological and nonpharmacological interventions utilized for thromboprophylaxis as well as flap salvage in microsurgery. A literature review was conducted in PubMed/National Center for Biotechnology Information, Scopus, Web of Science, and MEDLINE databases. Articles with a focus on thromboprophylaxis in microsurgical procedures spanning head and neck surgery, breast and extremity microvascular reconstruction, deep venous thrombosis/pulmonary embolus in microvascular surgery, and flap thrombosis and salvage were included in this review. The majority of available evidence supports mechanical venous thromboembolism (VTE) prophylaxis in all patients undergoing microsurgery given the presence of multiple risk factors for VTE within this particular patient population. Based on the literature review, addition of VTE chemoprophylactic agents is beneficial and an algorithmic approach to thromboprophylaxis in microsurgery patients and management of patients with thrombosis based on literature review and senior authors' experience is recommended and outlined.

Keywords

microsurgery - flap - thromboembolism - DVT - salvage - prophylaxis


Publication History

Article published online:
09 February 2023

© 2023. Thieme. All rights reserved.

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