How to predict clot formation? Rotational thromboelastometry in microsurgery
Microvascular tissue flap transfer is a complex surgical procedure designed to repair a tissue defect by transferring a fragment from another part of the body. This procedure restores both the form and function of the affected tissues and organs, ultimately enhancing the patient's quality of life. To do this successfully, it is necessary to connect the blood vessels in the tissue flap to those supplying blood to the area around the defect.
Despite significant technical advances in this microsurgical technique, thrombosis can still occur in the newly formed blood vessels, where blood clots form, preventing blood from reaching the tissue. Therefore,
the aim of Jevgeņijs Stepanovs' thesis was to identify potential risk factors that contribute to the development of thrombosis and to determine whether rotational thromboelastometry — a method that measures the clot formation time, clot firmness, and stability — can predict the potential development of flap thrombosis in patients at an early stage.
The thesis study included 153 patients with tissue defects caused by trauma, all of whom underwent microvascular flap transfer surgery at the Microsurgery and Plastic Surgery Centre of Latvia.
The study found that the risk of tissue flap thrombosis was increased by the presence of certain medical conditions, high levels of fibrinogen (a protein involved in blood clotting), prolonged surgery, and hypercoagulability (increased blood clotting, which raises the risk of clot formation), as measured by rotational thromboelastometry.
Rotational thromboelastometry analyser. Photo from Jevgeņijs Stepanovs' thesis
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