Abstract
The risk of total flap loss after free microvascular tissue transfer is estimated to be between 2 and 6%. Flap failure is most frequently due to anastomotic thrombosis, occurring in the early postoperative period. The exact causes of events leading to thrombotic occlusion still are not clearly elucidated, although authors have observed detrimental effects of increased platelet counts, platelets aggregation, and elevation of fibrinogen levels on flap survival. In patients with hyperfibinogenemia related to oral cancer, the safety of performing a successful microsurgical procedure for complex tissue defects has been debated, and the correlation between hyperfibrinogenemia and vascular thrombosis in microsurgery remains unclear.
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