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Autologous Breast Reconstruction Success Rates in Hypercoagulable Patients. | LitMetric

AI Article Synopsis

  • Hypercoagulable disorders can negatively impact microsurgical results, particularly in autologous breast reconstruction, leading to higher flap failure and complication rates.
  • The study analyzed outcomes from 2009 to 2020, comparing patients with thrombophilic disorders (TD) and those with a history of thrombotic events (TE) to control patients.
  • Results showed that patients with TD had a significantly higher risk of early flap loss, late partial loss, and delayed healing, while those with a TE history didn't show increased risk, indicating that TD poses greater challenges for successful breast reconstruction.

Article Abstract

Background: Hypercoagulable disorders may adversely affect microsurgical outcomes, including increased flap failure and complication rates. Outcomes specific to autologous breast reconstruction are not well described.

Methods: A retrospective review was performed of autologous breast reconstructions between 2009 and 2020. Patients with either a thrombophilic disorder (TD) diagnosis or a previous thrombotic event (TE) were identified. The analysis compared perioperative complications and flap success rates.

Results: In this series, 23 patients with a TD underwent 39 flaps, and 78 patients who had experienced a TE underwent 126 flaps, compared with 815 control patients, who underwent 1300 flaps. In logistic regression models, a TD diagnosis was an independent predictor of early total flap loss [OR, 8.42 (95% CI, 1.59 to 44.47); P = 0.01], late partial flap loss [OR, 3.9 (95% CI, 1.0 to 15.22); P = 0.05], and delayed healing [OR, 2.26 (95% CI, 1.02 to 5.04); P = 0.04]. TE history trended toward an association only with late partial flap loss ( P = 0.057). Flap salvage rates (25%) and flap success rates (92.3%) were statistically lower in patients with a TD but normal in patients who had experienced a TE.

Conclusions: Microsurgical breast reconstruction is a reasonable option for patients with hypercoagulation disorders. No increased risk of flap complications was associated with a previous TE; however, TDs carried increased risk.

Clinical Question/level Of Evidence: Risk, II.

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Source
http://dx.doi.org/10.1097/PRS.0000000000010708DOI Listing

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