MARC details
| 000 -LEADER |
|---|
| fixed length control field |
03695nam a22004457a 4500 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION |
|---|
| fixed length control field |
230411s20232023 xxu||||| |||| 00| 0 eng d |
| 022 ## - INTERNATIONAL STANDARD SERIAL NUMBER |
|---|
| International Standard Serial Number |
0032-1052 |
| 024 ## - OTHER STANDARD IDENTIFIER |
|---|
| Standard number or code |
00006534-990000000-01567 [pii] |
| 024 ## - OTHER STANDARD IDENTIFIER |
|---|
| Standard number or code |
10.1097/PRS.0000000000010293 [doi] |
| 040 ## - CATALOGING SOURCE |
|---|
| Original cataloging agency |
Ovid MEDLINE(R) |
| 099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC) |
|---|
| PMID |
36790787 |
| 245 ## - TITLE STATEMENT |
|---|
| Title |
Implementation of a Risk-Stratified Anticoagulation Protocol Increases Success of Lower Extremity Free Tissue Transfer in the Setting of Thrombophilia. |
| 251 ## - Source |
|---|
| Source |
Plastic & Reconstructive Surgery. 2023 Feb 14 |
| 252 ## - Abbreviated Source |
|---|
| Abbreviated source |
Plast Reconstr Surg. 2023 Feb 14 |
| 253 ## - Journal Name |
|---|
| Journal name |
Plastic and reconstructive surgery |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
|---|
| Year |
2023 |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
|---|
| Manufacturer |
FY2023 |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
|---|
| Publication date |
2023 Feb 14 |
| 265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE] |
|---|
| Publication status |
aheadofprint |
| 265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE] |
|---|
| Medline status |
Publisher |
| 266 ## - Date added to catalog |
|---|
| Date added to catalog |
2023-04-11 |
| 520 ## - SUMMARY, ETC. |
|---|
| Abstract |
CONCLUSION: Hypercoagulability can significantly impact microsurgical outcomes. Implementation of a risk-stratified AC protocol can significantly improve flap outcomes. Copyright © 2023 by the American Society of Plastic Surgeons. |
| 520 ## - SUMMARY, ETC. |
|---|
| Abstract |
INTRODUCTION: Optimal perioperative thromboprophylaxis is crucial to avoid flap thrombosis and to achieve high rates of microsurgical success. At our institution, implementation of a risk-stratified anticoagulation (AC) protocol preliminarily showed a reduction in postoperative thrombotic events and flap loss. We present an updated analysis of surgical outcomes using risk-stratified AC in thrombophilic patients who underwent free tissue transfer (FTT) reconstruction for non-traumatic lower extremity (LE) wounds. |
| 520 ## - SUMMARY, ETC. |
|---|
| Abstract |
METHODS: We retrospectively reviewed patients who underwent FTT to the LE from 2012 to 2021. Our risk-stratification AC protocol was implemented in July 2015. Low-risk and moderate-risk patients received subcutaneous heparin (SQH). High-risk patients received heparin infusion titrated to a goal PTT of 50-70 seconds. Prior to July 2015, non-stratified patients were treated with either SQH or low-dose heparin infusion (500 U/hour). Patients were divided into two cohorts (non-stratified and risk-stratified) based on date of FTT reconstruction. Primary outcomes included rates of postoperative complications, flap salvage, and flap success. |
| 520 ## - SUMMARY, ETC. |
|---|
| Abstract |
RESULTS: Two-hundred nineteen hypercoagulable patients who underwent FTT to LE were treated with non-stratified (n=26) or risk-stratified (n=193) thromboprophylaxis. Overall flap success rate was 96.8% (n=212). Flap loss was lower among risk-stratified patients (1.6% vs. 15.4%, p=0.004), which paralleled a significant reduction in postoperative thrombotic events (2.6% vs. 15.4%, p=0.013). Flap salvage was accomplished more often in the risk-stratified cohort (80% vs. 0%, p=0.048). Intraoperative anastomotic revision (OR: 6.10; p=0.035) and non-risk stratification (OR: 9.50; p=0.006) were independently associated with flap failure. |
| 546 ## - LANGUAGE NOTE |
|---|
| Language note |
English |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
IN PROCESS -- NOT YET INDEXED |
| 651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME |
|---|
| Institution |
MedStar Washington Hospital Center |
| 656 ## - INDEX TERM--OCCUPATION |
|---|
| Department |
MedStar General Surgery Residency |
| 656 ## - INDEX TERM--OCCUPATION |
|---|
| Department |
MedStar Georgetown University Hospital/MedStar Washington Hospital Center |
| 656 ## - INDEX TERM--OCCUPATION |
|---|
| Department |
Plastic Surgery Residency G |
| 656 ## - INDEX TERM--OCCUPATION |
|---|
| Department |
Surgery/Plastic Surgery |
| 657 ## - INDEX TERM--FUNCTION |
|---|
| Medline publication type |
Journal Article |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
|---|
| Local Authors |
Deldar, Romina |
| Institution Code |
MGUH |
| Program |
MedStar General Surgery Residency |
| Degree |
MD |
| Resident year |
Resident PGY 4 |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
|---|
| Local Authors |
Fan, Kenneth L |
| Institution Code |
MWHC |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
|---|
| Local Authors |
Zolper, Elizabeth |
| Institution Code |
MGUH |
| Program |
Plastic Surgery Residency |
| Degree |
MD |
| Resident year |
Resident PGY 2 |
| 790 ## - Authors |
|---|
| All authors |
Deldar R, Gupta N, Bovill JD, Zolper EG, Kim KG, Fan KL, Evans KK |
| 856 ## - ELECTRONIC LOCATION AND ACCESS |
|---|
| DOI |
<a href="https://dx.doi.org/10.1097/PRS.0000000000010293">https://dx.doi.org/10.1097/PRS.0000000000010293</a> |
| Public note |
https://dx.doi.org/10.1097/PRS.0000000000010293 |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) |
|---|
| Koha item type |
Journal Article |
| Item type description |
Article |
