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Free flap loss caused by heparin-induced thrombocytopenia and thrombosis (HITT): a case report and literature review

Heparin-induced thrombocytopenia and thrombosis (HITT) represents a dramatic condition that is difficult to diagnose because of nuanced clinical presentation. Therefore, in every case of microvascular thrombosis during heparin-therapy prompt suspicion about HITT is necessary to avoid flap necrosis....

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Detalles Bibliográficos
Autores principales: Segna, E., Bolzoni, A.R., Baserga, C., Baj, A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Pacini Editore SRL 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5317135/
https://www.ncbi.nlm.nih.gov/pubmed/28177337
http://dx.doi.org/10.14639/0392-100X-1188
Descripción
Sumario:Heparin-induced thrombocytopenia and thrombosis (HITT) represents a dramatic condition that is difficult to diagnose because of nuanced clinical presentation. Therefore, in every case of microvascular thrombosis during heparin-therapy prompt suspicion about HITT is necessary to avoid flap necrosis. We present a case of HITT which, as the 8 other articles reviewed, clearly shows that HITT is difficult to diagnose and complex to manage. Microvascular reconstruction is the first choice in head and neck reconstruction; unfortunately, dramatic outcomes in free flap surgery due to unpredictable thrombotic events are still reported in the English literature. More knowledge is required about HITT and reaching a consensus about thrombotic prevention in microsurgery could be helpful. Furthermore, a careful anamnesis can help minimise unexpected situations.