Full Blood Count Biomarkers for Prediction of Flap Complications in Microvascular Flap Surgery

Activity: Talk or presentation types › Poster presentation

Description

Advances in microvascular flap surgery have achieved a significant reduction in flap complications. Despite modern surgical techniques and anaesthetic considerations, the rate of flap loss remains significant. We propose the preoperative risk factor analysis as a tool for prevention of flap loss. Multiple risk factors have been identified yet there is limited data on commonly used laboratory biomarkers for prediction of flap loss. We aim to investigate the link between flap loss and a set of commonly used full blood count biomarkers.. This prospective cohort study includes 54 adult patients undergoing elective microvascular flap surgery. The study was conducted with the approval of the Ethics Committee of Riga Stradins University. Preoperative blood draws for analysis of full blood count were collected on the day of surgery before initiation of crystalloid infusion. Postoperative data on subsequent anastomosis revision and flap complications was obtained. Youdens Index was used for selection of cut-off values.. Flap loss with anastomosis revision occurred in 7.4% and other less severe flap complications occurred in 9.2% of cases. Malignancy was the primary indication for surgery in 59.3%, trauma in 13.0% and preceding defects in 27.7% of cases. Patients with flap loss were not different in gender, age, proportion of malignancy, choice of anaesthesia or ASA score from patients without complications. Patients with flap complications had higher preoperative hematocrit (40.8±3.2 vs 36.5±6.0; p=0.071) lower lymphocyte count (1.01±0.42 vs 1.66±0.84; p=0.09) and lower monocyte count (0.33±0.15 vs 0.55±0.32; p=0.043). Binary logistic regression revealed that a lymphocyte count below 1.49 increased odds of free flap loss (OR 9.95; CI95 1.13-87.7; p=0.039).. Our findings indicate that plasma lymphocyte count, monocyte count and hematocrit can be implied as predictive biomarkers for flap complications. Larger studies are needed to elucidate the concept of predictive biomarkers and specific cut-off values for prediction of flap loss.
Period29 Mar 2023
Event titleRSU International Research Conference 2023: Knowledge for Use in Practice
Event typeConference
OrganiserRīga Stradiņš University
LocationRiga, LatviaShow on map
Degree of RecognitionInternational

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