Chemoprophylaxis and Management of Venous Thromboembolism in Microvascular Surgery

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.

Exploring the Risk Factors for Deep Vein Thrombosis after Percutaneous Nephrolithotomy

“…However, it should be noted that not all studies have reached consistent conclusions [19]. Therefore, further large-scale clinical studies are still needed to verify the exact relationship between the Caprini RAM score and postoperative DVT and to determine its clinical application value in predicting and intervening in postoperative DVT [20].…”

Reliability of Long Vein Grafts for Reconstruction of Massive Wounds

“…The absence of thromboembolic events in our case series can be attributed to perioperative chemoprophylaxis use in this practice, but these data are not widely discussed in previous vein graft/free flap papers. While this practice is not universally implemented in reconstructive microsurgery cases, there is an increasing awareness of the importance of this clinical practice throughout plastic surgery [11].…”