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. 2025 Feb 14;13(2):e6544.
doi: 10.1097/GOX.0000000000006544. eCollection 2025 Feb.

Impact of COVID-19 on Thrombotic Complications in Microsurgery: Deep Inferior Epigastric Perforator Flap Outcomes Amid Pandemic

Daniel P Zaki  1 , Eric Zeng  2 , Mary L Duet  1 , Courtney E Stone  1 , Robert S Giglio  2 , Marion W Tapp  1 , Ramon Llull  1 , Bennett W Calder  1 , John M Robinson  1
Affiliations

Impact of COVID-19 on Thrombotic Complications in Microsurgery: Deep Inferior Epigastric Perforator Flap Outcomes Amid Pandemic

Daniel P Zaki et al. Plast Reconstr Surg Glob Open. .

Abstract

Background: Emerging research underscores the heightened risk of vasculitis and microvascular thrombosis in COVID-19 patients, alongside concerns about prothrombotic events post-severe acute respiratory syndrome coronavirus 2 vaccination. Following the pandemic's end, we sought a comprehensive analysis to elucidate its impact on microsurgical thrombosis rates, informed by empirical and anecdotal evidence.

Methods: An institutional review board-approved retrospective review analyzed autologous breast reconstruction cases in women from January 2019 to March 2022. Data on patient history, COVID-19 infection, vaccination status, and postoperative complications were collected. Patients were categorized as prepandemic and pandemic, and based on COVID-19 influence (infection or vaccination) for statistical evaluation.

Results: Among 527 patients, 216 underwent surgery prepandemic and 311 during the pandemic, revealing thrombotic event rates of 3.2% and 5.4%, respectively. Further comparative analysis showed no significant difference in thrombotic events among patients affected by COVID-19 through infection or vaccination during the pandemic.

Conclusions: Contrary to concerns, COVID-19 infection or vaccination status does not significantly increase thrombotic event rates in deep inferior epigastric perforator flap breast reconstructions. This study offers vital insights, affirming the safety and efficacy of microsurgical procedures amid the pandemic, thereby guiding microsurgeons in optimizing patient care in the post-COVID-19 era.

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Conflict of interest statement

The authors have no financial interest to declare in relation to the content of this article.

Figures

Fig. 1.
Fig. 1.
Thrombotic events before and after declaration of the COVID-19 pandemic.
Fig. 2.
Fig. 2.
Histogram illustrating the distribution of Caprini scores in 25 of the 27 total patients who experienced VTE postsurgery.
Fig. 3.
Fig. 3.
Incidence of flap failure and thrombosis based on COVID-19 status and date of surgery.
See this image and copyright information in PMC

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