Von Willebrand Factor Antigen, Biomarkers of Inflammation, and Microvascular Flap Thrombosis in Reconstructive Surgery

Rihards Peteris Rocans (Corresponding Author), Janis Zarins, Evita Bine, Insana Mahauri, Renars Deksnis, Margarita Citovica, Simona Donina, Indulis Vanags, Sabine Gravelsina, Anda Vilmane, Santa Rasa-Dzelzkaleja, Biruta Mamaja

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
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Abstract

Background: Microvascular flap surgery has become a routine option for defect correction. The role of von Willebrand factor antigen (VWF:Ag) in the pathophysiology of flap complications is not fully understood. We aim to investigate the predictive value of VWF:Ag for microvascular flap complications and explore the relationship between chronic inflammation and VWF:Ag. Methods: This prospective cohort study included 88 adult patients undergoing elective microvascular flap surgery. Preoperative blood draws were collected on the day of surgery before initiation of crystalloids. The plasma concentration of VWF:Ag as well as albumin, neutrophil-to-lymphocyte ratio (NLR), interleukin-6, and fibrinogen were determined. Results: The overall complication rate was 27.3%, and true flap loss occurred in 11.4%. VWF:Ag levels were higher in true flap loss when compared to patients without complications (217.94 IU/dL [137.27–298.45] vs. 114.14 [95.67–132.71], p = 0.001). Regression analysis revealed the association between VWF:Ag and true flap loss at the cutoff of 163.73 IU/dL (OR 70.22 [10.74–485.28], p = 0.043). Increased VWF:Ag concentrations were linked to increases in plasma fibrinogen (p < 0.001), C-reactive protein (p < 0.001), interleukin-6 (p = 0.032), and NLR (p = 0.019). Conclusions: Preoperative plasma VWF:Ag concentration is linked to biomarkers of inflammation and may be valuable in predicting complications in microvascular flap surgery.

Original languageEnglish
Article number5411
Number of pages10
JournalJournal of clinical medicine
Volume13
Issue number18
DOIs
Publication statusPublished - 12 Sept 2024

Keywords*

  • flap loss
  • microvascular flap complications
  • microvascular flap thrombosis
  • neutrophil-to-lymphocyte ratio
  • reconstructive surgery
  • von Willebrand factor antigen

Field of Science*

  • 3.2 Clinical medicine
  • 3.1 Basic medicine
  • 1.6 Biological sciences

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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