Objective: Postoperative use of anticoagulation after free tissue transfer in head and neck ablative procedures is common practice, but a clear protocol has not been well established. The outcome measures including total flap failure, thrombosis, and hematoma formation for different anticoagulation regimens in free tissue transfer in the head and neck were reviewed.
Data Sources: PubMed, Ovid, and Cochrane databases were examined for patients who underwent free tissue transfer following head and neck ablative procedures.
Review Methods: Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were utilized to identify English-language studies reporting anticoagulation regimens following free tissue transfer in head and neck ablative procedures. Outcomes included total flap failure, thrombosis, and hematoma formation. Two independent reviewers assessed the quality of the articles by using the Methodological Index for Non-Randomized Studies.
Results: A total of 368 articles were identified. An additional 36 articles were identified through screening of reference lists. Twenty-one of these studies met final inclusion criteria for qualitative analysis. Outcome data on total flap failure, thrombosis, and hematoma formation were extracted and analyzed for comparison against all anticoagulation regimens. Total flap failure, thrombosis, and hematoma formation rates were 4.4%, 4.5%, and 2.2%, respectively. Individual study rates ranged from 0.0% to 10.7%, 0.0% to 10.4%, and 0.6% to 7.2%, respectively.
Conclusions: There is not adequate evidence to develop a standardized anticoagulation protocol for head and neck free flap procedures. Comparable flap complications were reported between all the employed anticoagulation methods studied, though significant variability in study design among articles existed. Prospective, randomized studies are warranted to determine the optimal postoperative anticoagulation regimen following free tissue transfer of the head and neck. Laryngoscope, 128:412-421, 2018.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/lary.26703 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Importance of Frailty in Older Adults With Benign Paroxysmal Positioning Vertigo.
J Neurol Phys Ther
November 2024
Faculty of Rehabilitation Sciences, REVAL-Rehabilitation Research Centre, Hasselt University, Hasselt Diepenbeek, Limburg, Belgium (S.P., P.M., J.S.); Department of Otorhinolaryngology and Head & Neck Surgery, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Centre, The Netherlands (S.P., R.V.D.B); Department of Otorhinolaryngology, Head and Neck Surgery ZOL Hospital, Belgium (N.L., W.L.); and Department of Nutrition and Movement Sciences, NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University, The Netherlands (K.M.).
Background And Purpose: Even though Benign Paroxysmal Positioning Vertigo (BPPV) is one of the most reported vestibular disorders, its interaction with frailty and postural control in older adults is hardly or not investigated.
Methods: Thirty-seven older adults (≥65 years) with a diagnosis of BPPV (oaBPPV) (mean age 73.13 (4.
Effectiveness of Synchronous Postdischarge Contacts on Health Care Use and Patient Satisfaction : A Systematic Review and Meta-analysis.
Ann Intern Med
January 2025
Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System; Department of Population Health Sciences, Duke University School of Medicine; and Durham Evidence Synthesis Program, Durham Veterans Affairs Health Care System, Durham, North Carolina (J.M.G.).
Background: Postdischarge contacts (PDCs) after hospitalization are common practice, but their effectiveness in reducing use of acute care after discharge remains unclear.
Purpose: To assess the effects of PDC on 30-day emergency department (ED) visits, 30-day hospital readmissions, and patient satisfaction.
Data Sources: MEDLINE, Embase, and CINAHL searched from 2012 to 25 May 2023.
The impact of resident involvement and postgraduate year on head and neck surgery for obstructive sleep apnea.
PLoS One
January 2025
Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University, Richmond, Virginia, United States of America.
To assess the impact of resident involvement and resident postgraduate year (PGY) on head and neck obstructive sleep apnea (OSA) surgical outcomes. We analyzed head and neck OSA surgeries from 2005-2012 via the National Surgical Quality Improvement Program database. Demographic, preoperative, and postoperative variables were analyzed via multivariate regression to determine the impact of resident involvement and resident PGY on 30-day outcomes.
View Article and Find Full Text PDFImpact of sex hormones on pheochromocytomas, paragangliomas, and gastroenteropancreatic neuroendocrine tumors.
Eur J Endocrinol
January 2025
Department of Internal Medicine IV, LMU University Hospital, LMU Munich, 80336 Munich, Germany.
Objective: The effects of sex hormones remain largely unexplored in pheochromocytomas and paragangliomas (PPGLs) and gastroenteropancreatic neuroendocrine tumors (GEP-NETs).
Methods: We evaluated the effects of estradiol, progesterone, Dehydroepiandrosterone sulfate (DHEAS), and testosterone on human patient-derived PPGL/GEP-NET primary culture cell viability (n = 38/n = 12), performed next-generation sequencing and immunohistochemical hormone receptor analysis in patient-derived PPGL tumor tissues (n = 36).
Results: In PPGLs, estradiol and progesterone (1 µm) demonstrated overall significant antitumor effects with the strongest efficacy in PPGLs with NF1 (cluster 2) pathogenic variants.
Invited commentary: "Predicting disease-specific survival in patients undergoing active surveillance for papillary thyroid carcinoma".
World J Surg
January 2025
Yong Loo Lin School of Medicine, National University of Sinagpore, Singapore, Singapore.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!