Development of consensus guidelines for venous thromboembolism prophylaxis in patients undergoing microvascular reconstruction of the mandible

Frederic W B Deleyiannis, Julio A. Clavijo-Alvarez, Benson Pullikkotil, Rami Zanoun, Tiffany Behringer, Tae W. Chong, J. Peter Rubin, Jonas T. Johnson

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Background The purpose of this study was to determine how guidelines for venous thromboembolism prophylaxis can be applied to patients undergoing microsurgical reconstruction of the mandible. Methods Retrospective review of our institutional use of thromboprophylaxis and the associated outcomes in 114 patients (58 free fibular flaps and 56 osteocutaneous radial forearm flaps). Results Twenty-two patients (19.3%) received only intermittent pneumatic compression. Overall, 80.7% received postoperative chemoprophylaxis. Sixty-four percent initiated chemoprophylaxis within 24 hours after surgery. Only 13.2% received the recommended frequency of chemoprophylaxis. One patient had development of a pulmonary embolism. Four patients undergoing chemoprophylaxis had development of neck hematomas; in each case the cause of bleeding could be attributed to a cause distinct from chemoprophylaxis. Conclusions No consistent chemoprophylaxis protocol was followed. Chemoprophylaxis was not associated with an increased risk of bleeding. Physician education is the next step in decreasing variations in chemoprophylaxis and adopting guidelines similar to The American College of Chest Physicians.

Original languageEnglish (US)
Pages (from-to)1034-1040
Number of pages7
JournalHead and Neck
Volume33
Issue number7
DOIs
StatePublished - Jul 1 2011

Keywords

  • fibula free flap
  • guidelines
  • mandibular reconstruction
  • microsurgery
  • osteocutaneous free flap
  • prophylaxis, outcomes
  • radial forearm free flap
  • venous thromboembolism

ASJC Scopus subject areas

  • Otorhinolaryngology

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