Protein C deficiency in microvascular head and neck reconstruction.
OBJECTIVE
To determine the incidence of perioperative protein C deficiency in patients undergoing free flap reconstruction of cancer-related defects in the head and neck.


METHODS
Prospective case series.


METHODS
Ten patients underwent microvascular reconstruction after surgical therapy of carcinomas of the oral cavity or oropharynx. Coagulation studies were determined in all patients 72 hours after surgery.


METHODS
Academic tertiary care medical center


RESULTS
Protein C deficiency was detected in 70% of patients. One free flap failure was attributed to protein C deficiency.


CONCLUSIONS
Vitamin K-dependent clotting factors are frequently deficient during the postoperative period after major head and neck surgery, which may result in a state of hypercoagulability. Protein C deficiency should be considered as a possible cause of free flap thrombosis in patients who undergo microvascular head and neck reconstruction.
Ayala
C
C
Department of Surgery, University of California Los Angeles School of Medicine 90095, USA.
Blackwell
K E
KE
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000150:complications / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D020151:Protein C Deficiency / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D013524:Surgical Flaps / Q000098:blood supply / Q000473:pathology; D013923:Thromboembolism / Q000209:etiology / Q000473:pathology; D014813:Vitamin K Deficiency / Q000150:complications