Microvascular tissue transfer in a pregnant patient

Mimi Leong, Mark S. Granick

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Pregnancy is a relative contraindication for elective surgery. The primary concerns are for the safety of the fetus and the mother. However, there are particular problems involving microvascular surgery clue to the pregnancy-associated hypercoagulable state. The authors were presented with a 35-year woman, 20 weeks pregnant, with a degloved foot and ankle associated with an open distal tibia/fibula fracture (Gustilo IIIB). Salvage of her leg required a microvascular tissue transfer. Accordingly, a combined latissimus dorsi-serratus anterior free flap was performed with a saphenous vein graft to the popliteal vessels. The patient was hypercoagulable and there were extensive platelet clots. Her consumption of heparin was enormous. Postoperatively, she was treated with intravenous dextran for 5 clays and for 17 days with intravenous heparin. After discharge, she was placed on subcutaneous heparin until she delivered a healthy baby. The flap survived and her leg was salvaged. The hypercoagulable state of pregnancy, as well as thromboprophylaxis, are discussed.

Original languageEnglish (US)
Pages (from-to)411-415
Number of pages5
JournalJournal of Reconstructive Microsurgery
Issue number6
StatePublished - Aug 1998
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery


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