Perioperative thromboelastography evaluation in70free flap transplantations for oral, maxillofacial reconstruction

doi:10.19438/j.cjoms.2022.03.007

Abstract

Abstract: PURPOSE: To investigate the clinical value of thromboelastography (TEG) in prevention of thrombosis of free flap anastomosis during perioperative period of oral and maxillofacial defects reconstructed with free flap. METHODS: The clinical data of 70 patients with oral and maxillofacial defects repaired with free flap were analyzed retrospectively. According to different coagulation test methods and anticoagulation guidelines, the patients were divided into control group (routine coagulation test, anticoagulation treatment according to routine coagulation indexes) and experimental group (TEG test and routine coagulation test, anticoagulation treatment according to TEG indexes), with 35 cases in each group, their coagulation status and complications such as flap thrombosis and hematoma, etc. were compared. SPSS24.0 software package was used for statistical analysis. RESULTS: The levels of activated partial thromboplastin time(APTT) and plasma thrombin time(TT) of routine coagulation test in the two groups decreased successively at three time points, and the level of fibrinogen (FIB) increased at three time points. There was no significant difference between the two groups (P>0.05); the difference of international normalized ratio (INR) at three time points was not statistically significant (P>0.05). There was no significant difference in Angle, MA, LY30% and EPL at three time points in TEG of the experimental group (P>0.05). The values of R and K decreased successively at three time points, and the difference was statistically significant (P<0.05); before operation and 24h after operation, the number of positive cases of hypercoagulable patients in TEG test was greater than that in routine coagulation test, and the difference was statistically significant(P<0.05). There was no significant difference in flap complications between the two groups (P>0.05). CONCLUSIONS: The detection rate of TEG in hypercoagulable patients was higher than that in routine coagulation test; the results of TEG and routine coagulation test have clinical reference value for the use of anticoagulants.

Key words: Oral and maxillofacial defect, Free flap, Routine coagulation test, Thromboelastogram

CLC Number:

R782.05

LIU Di, ZHANG Si-min, ADILIJIANG Saimaiti, ZULIHUMA Kadi, MUHESEN Yashengjiang, NIJIATI Nuermuhanmode, MAIMAITITUXUN Tuerdi. Perioperative thromboelastography evaluation in70free flap transplantations for oral, maxillofacial reconstruction[J]. China Journal of Oral and Maxillofacial Surgery, 2022, 20(3): 244-250.

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