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The Incidence of Venous Thromboembolism After Oncologic Head and Neck Reconstruction

Chen, Constance M. MD, MPH; Disa, Joseph J. MD, FACS; Cordeiro, Peter G. MD, FACS; Pusic, Andrea L. MD, MHS; McCarthy, Colleen M. MD, MPH; Mehrara, Babak J. MD, FACS

doi: 10.1097/SAP.0b013e31816fd7e7
Northeastern Society of Plastic Surgeons

This study evaluates the incidence of symptomatic deep venous thrombosis and pulmonary embolism after head and neck reconstruction at a single tertiary care cancer center. From 1997 to 2006, 6,759 surgical procedures were performed. There were 1,591 head and neck reconstructions (n = 1,591) and 5,168 non-head and neck reconstructions (n = 5,168). Free flaps, regional flaps, and other procedures were included. Although the incidence of venous thromboembolism (VTE) was less than 1% in both patient populations, there was a significantly greater incidence of VTE among patients undergoing head and neck reconstruction than non-head and neck reconstruction (P < 0.05). When compared with patients undergoing non-head and neck reconstruction, patients undergoing oncologic head and neck procedures were older, underwent longer anesthesia times, spent more days in the hospital, and were more likely to need free flaps. When possible, appropriate prophylaxis against VTE in cancer patients under going head and neck reconstruction is recommended.

From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY.

Received December 9, 2007 and accepted for publication February 9, 2008.

This study was approved by the Institutional Review Board of Memorial Sloan-Kettering Cancer Center.

Presented at the 24th Meeting of the Northeastern Society of Plastic Surgeons, October 6, 2007.

None of the authors have a financial interest or commercial association with information submitted in this manuscript. No products, devices, or drugs were used or identified in the manuscript.

Reprints: Babak J. Mehrara, MD, 1275 York Avenue, New York, NY 10021. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.