Venous Thromboembolism in Lower Extremity Reconstruction | Dr. Daniel Gould

Dr. Daniel Gould co-authored this study published in Annals of Plastic Surgery, examining how perioperative venous thromboembolism (VTE) affects outcomes in patients undergoing soft tissue reconstruction following traumatic lower extremity injuries.

Venous thromboembolism, which includes deep vein thrombosis and pulmonary embolism, represents a serious potential complication surrounding major surgery and trauma. For patients requiring complex reconstruction of the lower extremities, these risks can add another layer of complexity to surgical planning and postoperative management.

The researchers retrospectively reviewed 190 patients with traumatic lower extremity injuries who underwent local or free flap reconstruction. Twelve patients developed clinically apparent VTE during their hospitalization, with most cases identified before soft tissue reconstruction.

Despite the presence of VTE, all affected patients achieved successful limb salvage, and no flap losses occurred within this group. Overall flap complication rates were also similar between patients with and without VTE. However, patients with diagnosed VTE who underwent free flap reconstruction demonstrated an increased risk of postoperative hematoma.

The findings demonstrate that successful limb salvage and soft tissue reconstruction can still be achieved in patients experiencing perioperative VTE. At the same time, the study underscores the importance of appropriate anticoagulation, careful monitoring, and thoughtful perioperative management given the potentially serious consequences associated with thromboembolic events.