TY - JOUR
T1 - Reactive thromobocytosi alone does not affect the patency of microvascular anastomosis in the splenectomy rat
AU - Kuo, Yur Ren
AU - Yang, Kuender D.
AU - Yang, Ming Yi
AU - Huang, Mong Na Lo
AU - Lin, Chein Wei
AU - Lin, Fu Chein
AU - Wei, Fu Chan
AU - Jeng, Seng Feng
PY - 2002/9/1
Y1 - 2002/9/1
N2 - Vascular thrombosis is a harbinger of failure in microsurgery. However, there is still controversy regarding the correlation of the complications of thrombocytosis and thrombosis. Some evidence indicates that patients with elevated platelet counts tend to have a higher flap failure rate, and surgeons usually hesitate to operate on patients with thrombocytosis. Nevertheless, the authors have experienced successful free tissue transfer in seven patients with thrombocytosis resulting from traumatic splenectomy or multiple trauma. On the basis of clinical observation, the authors investigated whether reactive thrombocytosis contributes to the patency of a microvascular anastomosis. In a rodent splenectomy-induced thrombocytosis model (n= 40), stable reactive thrombocytosis occurred after postoperative days 5 to 10, with the peak on postoperative day 7. Femoral artery division and reanastomosis was performed in rats with or without splenectomy-induced thrombocytosis, and vascular patency was assessed. Platelet counts and platelet activation were studied in correlation to microvascular patency. Platelet activation as demonstrated by CD62P expression on platelets was not significantly different between rats with and without thrombocytosis (6.41 ± 0.95 percent versus 4.51 ± 0.55 percent, respectively; p = 0.089). As immature platelets were not increased (2.86 ± 0.33 percent versus 1.99 ± 0.32 percent, p = 0.074), it seems that the splenectomy-induced thrombocytosis is the result of redistribution of platelets instead of an increase in bone marrow production. There were no significant differences in the patency rates or perfusion units of femoral artery after arterial anastomosis between rats with and without thrombocytosis (90 percent and 95 percent, respectively; p = 0.561). In conclusion, this study demonstrates that microvascular anastomosis can be performed safely in patients with reactive thrombocytosis without platelet activation.
AB - Vascular thrombosis is a harbinger of failure in microsurgery. However, there is still controversy regarding the correlation of the complications of thrombocytosis and thrombosis. Some evidence indicates that patients with elevated platelet counts tend to have a higher flap failure rate, and surgeons usually hesitate to operate on patients with thrombocytosis. Nevertheless, the authors have experienced successful free tissue transfer in seven patients with thrombocytosis resulting from traumatic splenectomy or multiple trauma. On the basis of clinical observation, the authors investigated whether reactive thrombocytosis contributes to the patency of a microvascular anastomosis. In a rodent splenectomy-induced thrombocytosis model (n= 40), stable reactive thrombocytosis occurred after postoperative days 5 to 10, with the peak on postoperative day 7. Femoral artery division and reanastomosis was performed in rats with or without splenectomy-induced thrombocytosis, and vascular patency was assessed. Platelet counts and platelet activation were studied in correlation to microvascular patency. Platelet activation as demonstrated by CD62P expression on platelets was not significantly different between rats with and without thrombocytosis (6.41 ± 0.95 percent versus 4.51 ± 0.55 percent, respectively; p = 0.089). As immature platelets were not increased (2.86 ± 0.33 percent versus 1.99 ± 0.32 percent, p = 0.074), it seems that the splenectomy-induced thrombocytosis is the result of redistribution of platelets instead of an increase in bone marrow production. There were no significant differences in the patency rates or perfusion units of femoral artery after arterial anastomosis between rats with and without thrombocytosis (90 percent and 95 percent, respectively; p = 0.561). In conclusion, this study demonstrates that microvascular anastomosis can be performed safely in patients with reactive thrombocytosis without platelet activation.
UR - https://www.scopus.com/pages/publications/0036707539
U2 - 10.1097/00006534-200209010-00014
DO - 10.1097/00006534-200209010-00014
M3 - 文章
C2 - 12172143
AN - SCOPUS:0036707539
SN - 0032-1052
VL - 110
SP - 812
EP - 817
JO - Plastic and Reconstructive Surgery
JF - Plastic and Reconstructive Surgery
IS - 3
ER -