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Vascularized Free Tissue Transfer in a Patient with Hemophilia B: Case Report and Literature Review

Hemophilia is a blood disorder characterized by impairment of the coagulation cascade leading to an increased bleeding risk (Kauffman, 2014). As such, surgical management of these patients can become difficult and well-defined surgical guidelines are not yet in place (Assoumane et al., 2017). Close...

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Autores principales: Qaisi, Mohammed, Kierce, Justin, Murphy, James
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6954477/
https://www.ncbi.nlm.nih.gov/pubmed/31976116
http://dx.doi.org/10.1155/2019/5430786
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author Qaisi, Mohammed
Kierce, Justin
Murphy, James
author_facet Qaisi, Mohammed
Kierce, Justin
Murphy, James
author_sort Qaisi, Mohammed
collection PubMed
description Hemophilia is a blood disorder characterized by impairment of the coagulation cascade leading to an increased bleeding risk (Kauffman, 2014). As such, surgical management of these patients can become difficult and well-defined surgical guidelines are not yet in place (Assoumane et al., 2017). Close monitoring of perioperative factor levels may be even more crucial for those undergoing microvascular free tissue transfer. This is because either a hypercoagulable or hypocoagulable bleeding state has the potential to further increase the risk of vascular compromise to the flap. We report a successful case of mandibular reconstruction using a free fibular flap in a patient with severe hemophilia B and the protocols we used, as well as a review of the literature of similar cases. In the literature, we identified 6 cases of microvascular free tissue transfer in patients with hemophilia; two of these cases had complications which were both related to excess bleeding. It is crucial that these cases be managed in a multidisciplinary fashion in close consultation with a hematologist. The role of venothromboembolism (VTE) prophylaxis in the hemophilic patient undergoing free tissue transfer is discussed.
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spelling pubmed-69544772020-01-23 Vascularized Free Tissue Transfer in a Patient with Hemophilia B: Case Report and Literature Review Qaisi, Mohammed Kierce, Justin Murphy, James Case Rep Surg Case Report Hemophilia is a blood disorder characterized by impairment of the coagulation cascade leading to an increased bleeding risk (Kauffman, 2014). As such, surgical management of these patients can become difficult and well-defined surgical guidelines are not yet in place (Assoumane et al., 2017). Close monitoring of perioperative factor levels may be even more crucial for those undergoing microvascular free tissue transfer. This is because either a hypercoagulable or hypocoagulable bleeding state has the potential to further increase the risk of vascular compromise to the flap. We report a successful case of mandibular reconstruction using a free fibular flap in a patient with severe hemophilia B and the protocols we used, as well as a review of the literature of similar cases. In the literature, we identified 6 cases of microvascular free tissue transfer in patients with hemophilia; two of these cases had complications which were both related to excess bleeding. It is crucial that these cases be managed in a multidisciplinary fashion in close consultation with a hematologist. The role of venothromboembolism (VTE) prophylaxis in the hemophilic patient undergoing free tissue transfer is discussed. Hindawi 2019-12-29 /pmc/articles/PMC6954477/ /pubmed/31976116 http://dx.doi.org/10.1155/2019/5430786 Text en Copyright © 2019 Mohammed Qaisi et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Qaisi, Mohammed
Kierce, Justin
Murphy, James
Vascularized Free Tissue Transfer in a Patient with Hemophilia B: Case Report and Literature Review
title Vascularized Free Tissue Transfer in a Patient with Hemophilia B: Case Report and Literature Review
title_full Vascularized Free Tissue Transfer in a Patient with Hemophilia B: Case Report and Literature Review
title_fullStr Vascularized Free Tissue Transfer in a Patient with Hemophilia B: Case Report and Literature Review
title_full_unstemmed Vascularized Free Tissue Transfer in a Patient with Hemophilia B: Case Report and Literature Review
title_short Vascularized Free Tissue Transfer in a Patient with Hemophilia B: Case Report and Literature Review
title_sort vascularized free tissue transfer in a patient with hemophilia b: case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6954477/
https://www.ncbi.nlm.nih.gov/pubmed/31976116
http://dx.doi.org/10.1155/2019/5430786
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