{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:06:27Z","timestamp":1788566787198,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,11,18]],"date-time":"2019-11-18T00:00:00Z","timestamp":1574035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Complications after microvascular surgery, such as partial flap loss, and arterial\/venous compromise cannot only increase morbidity for the patient but also tax the healthcare system. Thrombocytosis, both essential and reactive, can predispose patients to thrombosis and hemorrhage and thus should intuitively have an effect on the outcome of microvascular free tissue transfers. We sought to evaluate the effect of preoperative thrombocytosis on outcomes after microvascular free flap surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of the 2013\u20132016 American Collges of Surgeons, National Surgical Quality Improvement Program (ACS NSQIP) database identified 4,299 patients who had microsurgical flaps. Of these 3,744 had preoperative platelet levels recorded. Fifty\u2010four patients had preoperative thrombocytosis, defined as a platelet count &gt;450\u2009K\/CUMM, while 3,690 did not. The groups were compared; demographics, comorbidities, and smoking status were recorded. We then examined outcomes between groups including average operative time, length of hospital stay, need for transfusion, deep vein thrombosis (DVT) postoperatively, and need for reoperation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>When comparing the two cohorts, there was no statistical difference in comorbidities. We found a significant difference between the thrombocytosis and control cohort in need for transfusion (29.6 vs. 12.8%, <jats:italic>p<\/jats:italic> =\u2009.0002), average days till discharge (8.36 vs. 5.75, <jats:italic>p<\/jats:italic> =\u2009.009), and need for reoperation (27.8 vs. 13.8%, <jats:italic>p<\/jats:italic> =\u2009.003). There was no difference in DVT occurrence (0 vs. 0.1%, <jats:italic>p<\/jats:italic> =\u2009.46) or average operation time (535\u2009m vs. 482\u2009min, <jats:italic>p<\/jats:italic> =\u2009.088).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with thrombocytosis undergoing microvascular free flaps are at increased risk for complications, including the need for a blood transfusion, prolonged hospital stays, and reoperation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30530","type":"journal-article","created":{"date-parts":[[2019,11,18]],"date-time":"2019-11-18T14:40:53Z","timestamp":1574088053000},"page":"288-297","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Thrombocytosis is associated with complications after microvascular surgery: An NSQIP data analysis"],"prefix":"10.1002","volume":"40","author":[{"given":"Sami P.","family":"Tarabishy","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery Medical University of South Carolina  Charleston South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dani","family":"Inglesby","sequence":"additional","affiliation":[{"name":"College of Medicine Medical University of South Carolina  Charleston South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Tapp","sequence":"additional","affiliation":[{"name":"College of Medicine Medical University of South Carolina  Charleston South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Del","family":"Corral","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Medstar Georgetown University Hospital  Washington District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6957-0413","authenticated-orcid":false,"given":"Fernando A.","family":"Herrera","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery Medical University of South Carolina  Charleston South Carolina"},{"name":"Department of Surgery, Ralph H Johnson Veterans Affairs Medical Center  Charleston South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pathol.2017.04.001"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001138"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3816\/CBC.2002.n.008"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22406"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002893"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1381955"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-199605000-00010"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-017-3099-2"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1311687"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2012.04846.x"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-018-3854-6"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-200301000-00010"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000019719.05863.BO"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22243"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31825dbfb7"},{"issue":"6","key":"e_1_2_7_17_1","first-page":"792","article-title":"Extreme thrombocytosis and cardiovascular surgery: Risks and management","volume":"39","author":"Natelson E. A.","year":"2012","journal-title":"Texas Heart Institute Journal"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/289563"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1613413"},{"key":"e_1_2_7_20_1","unstructured":"Tefferi A.(2019).Approach to the patient with Thrombocytosis. [online] Uptodate.com. Available fromhttps:\/\/www.uptodate.com\/contents\/approach-to-the-patient-with-thrombocytosis?search=thrombocytosis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31823aec4d"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.30530","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/micr.30530","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.30530","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T05:20:07Z","timestamp":1693372807000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.30530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,18]]},"references-count":20,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1002\/micr.30530"],"URL":"https:\/\/doi.org\/10.1002\/micr.30530","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"value":"0738-1085","type":"print"},{"value":"1098-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,18]]},"assertion":[{"value":"2019-04-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-10-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}