Skip to main content
SpringerLink
Log in

Head and neck free tissue transfer in a patient with factor V Leiden: case report and review of the literature

  • Case Report
  • Published:
Oral and Maxillofacial Surgery Aims and scope Submit manuscript

Abstract

Hypercoagulable disorders can compromise success of free flap reconstruction. Factor V Leiden is one such disorder for which only one previously reported case of successful free tissue transfer in the head and neck has been described. We report a 70-year-old woman with factor V Leiden treated for stage IVA squamous cell carcinoma of the mandible with a composite resection and reconstruction with an osteocutaneous scapular free tissue transfer. The free tissue transfer occurred without complications, in the setting of intraoperative heparin, postoperative aspirin, and enoxaparin. The free tissue transfer continues to be viable at her most recent follow-up appointment. The hypercoagulable patient represents a diverse presentation of increased coagulation risk in the perioperative period. Considering a patient’s history and understanding available treatment adjuncts can factor heavily in a patient with factor V Leiden successfully undergoing free tissue transfer for head and neck defects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Abouyared M, Katz AP, Ein L, Ketner J, Sargi Z, Nicolli E, Leibowitz JM (2019) Controversies in free tissue transfer for head and neck cancer: a review of the literature. Head Neck 41:3457–3463

    Article  Google Scholar 

  2. Suh JD, Sercarz JA, Abemayor E, Calcaterra TC, Rawnsley JD, Alam D, Blackwell KE (2004) Analysis of outcome and complications in 400 cases of microvascular head and neck reconstruction. Arch Otolaryngol Head Neck Surg 130:962–966

    Article  Google Scholar 

  3. Bui DT, Cordeiro PG, Hu QY, Disa JJ, Pusic A, Mehrara BJ (2007) Free flap reexploration: indications, treatment, and outcomes in 1193 free flaps. Plast Reconstr Surg 119:2092–2100

    Article  CAS  Google Scholar 

  4. Gregg JP, Yamane AJ, Grody WW (1997) Prevalence of the factor V-Leiden mutation in four distinct American ethnic populations. Am J Med Genet 73:334–336

    Article  CAS  Google Scholar 

  5. Ridker PM, Miletich JP, Hennekens CH, Buring JE (1997) Ethnic distribution of factor V Leiden in 4047 men and women. Implications for venous thromboembolism screening. JAMA 277:1305–1307

    Article  CAS  Google Scholar 

  6. Nguyen T, Egan K, Crowe D, Nazir N, Przylecki W, Andrews B (2020) Outcomes of head and neck reconstruction in hypercoagulable patients. J Reconstr Microsurg 36(04):271–275

    Article  Google Scholar 

  7. Zavlin D, Steinberg AJ, Chegireddy V, Spiegel AJ (2018) Two successful cases of DIEP flaps for breast reconstruction in patients with Factor V Leiden. J Surg Case Rep 2018:rjy231

    Article  Google Scholar 

  8. Handschin AE, Guggenheim M, Calcagni M, Künzi W, Giovanoli P, Factor V (2010) Leiden mutation and thrombotic occlusion of microsurgical anastomosis after free TRAM flap. Clin Appl Thromb Hemost 16:199–203

    Article  CAS  Google Scholar 

  9. Wang TY, Serletti JM, Cuker A, McGrath J, Low DW, Kovach SJ, Wu LC (2012) Free tissue transfer in the hypercoagulable patient: a review of 58 flaps. Plast Reconstr Surg 129:443–453

    Article  CAS  Google Scholar 

  10. Spiegel JH, Polat JK (2007) Microvascular flap reconstruction by otolaryngologists: prevalence, postoperative care, and monitoring techniques. Laryngoscope 117:485–490

    Article  Google Scholar 

  11. Nelson JA, Chung CU, Bauder AR, Wu LC (2017) Prevention of thrombosis in hypercoagulable patients undergoing microsurgery: a novel anticoagulation protocol. J Plast Reconstr Aesthet Surg 70:307–312

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial/Head and Neck Surgery, Division of Head and Neck Oncology and Reconstructive Surgery, LSU Health Sciences Center Shreveport, Shreveport, LA, USA

    Ricardo Lugo, Fawaz Alotaibi, Brett Shirley, Dongsoo David Kim & Stavan Patel

  2. Department of Oral Medicine, Division of Oral & Maxillofacial Surgery, Geisinger Health, PA, Danville, USA

    Paul Covello

Authors
  1. Ricardo Lugo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fawaz Alotaibi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brett Shirley
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dongsoo David Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Paul Covello
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Stavan Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ricardo Lugo.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

LSU Health Sciences Center Shreveport waives Institutional Review Board (IRB) approval for case reports/series involving 1-2 patients/records.

Consent to participate

Not applicable.

Consent for publication

Written informed consent for publication of their clinical details and clinical images was obtained from the patient. A copy of the consent form is available for review by the editor of this journal.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lugo, R., Alotaibi, F., Shirley, B. et al. Head and neck free tissue transfer in a patient with factor V Leiden: case report and review of the literature. Oral Maxillofac Surg 25, 571–574 (2021). https://doi.org/10.1007/s10006-021-00939-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10006-021-00939-x

Keywords

Search

Navigation