title: Parameters predicting complications in flap surgery.
abstract: OBJECTIVE
  The aim of this prospective study was to determine laboratory parameters predicting complications and/or failure in flap surgery.
  
  
  METHODS
  Fifty-seven patients undergoing reconstructive surgery with cutaneous free and pedicled flaps were included. Blood samples were taken 2 days before surgery and 1, 3, 5, 7, and 14 days after. Parameters associated with thrombophilia, bleeding disorders, and wound healing were determined.
  
  
  RESULTS
  In 45 (77%) of 57 patients no complications occurred. Bleeding (9%) and venous thrombosis of the flaps (9%) led in 18% of the cases to surgical revisions. Activated protein C resistance showed a significant (P < .05) cluster in cases with venous thrombosis, whereas it was absent in all other cases. Fibrinogen, factor VIII:C, von Willebrand factor (vWF) activity, and VWF antigen were significantly (P < .05) higher in patients with venous thrombosis compared with all other patients.
  
  
  CONCLUSIONS
  Laboratory parameters of thrombosis and bleeding appear to be associated with complications in flap surgery.
authors.affiliation: Department for Cranio- and Maxillofacial Surgery, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany. handschel@med.uni-duesseldorf.de
authors.forename: Jörg
authors.initials: J
authors.lastname: Handschel
authors.forename: Stefan
authors.initials: S
authors.lastname: Burghardt
authors.forename: Christian
authors.initials: C
authors.lastname: Naujoks
authors.forename: Norbert R
authors.initials: NR
authors.lastname: Kübler
authors.forename: Günter
authors.initials: G
authors.lastname: Giers
mesh_terms: D020016:Activated Protein C Resistance / Q000209:etiology; D001780:Blood Coagulation Tests; D002097:C-Reactive Protein / Q000032:analysis; D005169:Factor VIII / Q000032:analysis; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005500:Follow-Up Studies; D005544:Forecasting; D058752:Free Tissue Flaps / Q000009:adverse effects; D006403:Hematologic Tests; D006474:Hemorrhagic Disorders / Q000097:blood; D006801:Humans; D008297:Male; D009336:Necrosis; D010979:Platelet Function Tests; D011183:Postoperative Complications; D019106:Postoperative Hemorrhage / Q000209:etiology; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D012086:Reoperation; D016038:Skin Transplantation / Q000009:adverse effects; D013524:Surgical Flaps / Q000009:adverse effects; D019851:Thrombophilia / Q000097:blood; D013927:Thrombosis / Q000097:blood / Q000209:etiology; D020246:Venous Thrombosis / Q000097:blood / Q000209:etiology; D014841:von Willebrand Factor / Q000032:analysis / Q000276:immunology
chemical_list: C029417:Von Willebrand antigen; D014841:von Willebrand Factor; D005169:Factor VIII; D005340:Fibrinogen; D002097:C-Reactive Protein