Heparin-induced thrombocytopenia syndrome as a cause of flap failure: A report of two cases

Exposed tibial bone after burns: Flap reconstruction versus dermal substitute

“…It is only at a later stage that the probability of heparininduced thrombocytopenia syndrome [7][8][9][10][11][12][13] was revealed, as a possible major contributor to the four consecutive flap failures we observed.…”

Evidence to Support Controversy in Microsurgery

“…157 Heparin is not without its complications, as heparin-induced thrombocytopenia-related congestion is a reported cause of free flap failure (Level V Evidence). 158 Postoperative ketorolac may be protective against vascular thrombosis, with the added benefit of pain control (Level III Evidence). 159 In conclusion, there is still controversy regarding the most effective anticoagulation protocol for free flap surgery.…”

Free flap failure caused by heparin‐induced thrombocytopenia

“…2 In the first case report, venous congestion occurred on the 2nd postoperative day, and in the second case report, it occurred 6 hours after exposure. 3,4 The rapid onset in both of these cases suggests recent prior heparin exposure and sensitization. A normal immune-mediated reaction without prior exposure takes 4-14 days to have an effect as seen in our case.…”