{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T18:06:24Z","timestamp":1779300384101,"version":"3.51.4"},"reference-count":27,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["americanjournalofsurgery.com","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The American Journal of Surgery"],"published-print":{"date-parts":[[2026,2]]},"DOI":"10.1016\/j.amjsurg.2025.116730","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T17:27:24Z","timestamp":1763659644000},"page":"116730","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"special_numbering":"C","title":["Strategies to minimize postoperative complications in microsurgical free tissue transfer: The role of anticoagulation, antiplatelets, and ambulation"],"prefix":"10.1016","volume":"252","author":[{"given":"Erika T.","family":"Shock","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brooke E.","family":"Porter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7549-6773","authenticated-orcid":false,"given":"Farrell K.","family":"Landwehr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela V.","family":"Atkinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie S.","family":"Raatz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin M.","family":"Klifto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas D.","family":"Willson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.amjsurg.2025.116730_bib1","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1055\/s-0042-1759795","article-title":"Free flap donor-site complications and management","volume":"37","author":"Archibald","year":"2023","journal-title":"Semin Plast Surg"},{"key":"10.1016\/j.amjsurg.2025.116730_bib2","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jormas.2017.03.007","article-title":"Efficacy of the postoperative management after microsurgical free tissue transfer","volume":"118","author":"Sigaux","year":"2017","journal-title":"J Stomatol Oral Maxillofac Surg"},{"key":"10.1016\/j.amjsurg.2025.116730_bib3","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1097\/PRS.0000000000000839","article-title":"Emerging paradigms in perioperative management for microsurgical free tissue transfer: review of the literature and evidence-based guidelines","volume":"135","author":"Motakef","year":"2015","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.amjsurg.2025.116730_bib4","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/01.prs.0000264077.07779.50","article-title":"Timing of presentation of the first signs of vascular compromise dictates the salvage outcome of free flap transfers","volume":"120","author":"Chen","year":"2007","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.amjsurg.2025.116730_bib5","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1097\/00006534-199612000-00017","article-title":"Timing of pedicle thrombosis and flap loss after free-tissue transfer","volume":"98","author":"Kroll","year":"1996","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.amjsurg.2025.116730_bib6","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.anplas.2010.01.002","article-title":"M\u00e9decine factuelle et pr\u00e9vention de la thrombose en microchirurgie. Revue critique de la litt\u00e9rature","volume":"56","author":"Dumont","year":"2011","journal-title":"Annales de Chirurgie Plastique Esth\u00e9tique"},{"key":"10.1016\/j.amjsurg.2025.116730_bib7","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1016\/j.bjps.2015.05.011","article-title":"Management of perioperative microvascular thrombotic complications \u2013 the use of multiagent anticoagulation algorithm in 395 consecutive free flaps","volume":"68","author":"Senchenkov","year":"2015","journal-title":"J Plast Reconstr Aesthetic Surg"},{"key":"10.1016\/j.amjsurg.2025.116730_bib8","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/00006534-199708000-00012","article-title":"1457 years of microsurgical experience","volume":"100","author":"Glicksman","year":"1997","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.amjsurg.2025.116730_bib9","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1097\/SAP.0b013e31816fd7e7","article-title":"The incidence of venous thromboembolism after oncologic head and neck reconstruction","volume":"60","author":"Chen","year":"2008","journal-title":"Ann Plast Surg"},{"key":"10.1016\/j.amjsurg.2025.116730_bib10","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1097\/01.sap.0000264837.15110.2f","article-title":"The effect of postoperative anticoagulation on microvascular thrombosis","volume":"59","author":"Ashjian","year":"2007","journal-title":"Ann Plast Surg"},{"key":"10.1016\/j.amjsurg.2025.116730_bib11","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/S0094-1298(20)30795-1","article-title":"Avoiding free flap failure","volume":"19","author":"Khouri","year":"1992","journal-title":"Clin Plast Surg"},{"key":"10.1016\/j.amjsurg.2025.116730_bib12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2147\/CLEP.S4780","article-title":"Venous and arterial thrombosis: two aspects of the same disease?","volume":"1","author":"Prandoni","year":"2009","journal-title":"Clin Epidemiol"},{"key":"10.1016\/j.amjsurg.2025.116730_bib13","doi-asserted-by":"crossref","first-page":"1224E","DOI":"10.1097\/PRS.0000000000010695","article-title":"Unfractionated heparins, low-molecular-weight heparins, and indirect factor Xa inhibitors in plastic and reconstructive surgery: an evidence-based review","volume":"153","author":"Othman","year":"2024","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.amjsurg.2025.116730_bib14","doi-asserted-by":"crossref","DOI":"10.1155\/2015\/120903","article-title":"Increased postoperative bleeding risk among patients with local flap surgery under continued clopidogrel therapy","volume":"2015","author":"Eichhorn","year":"2015","journal-title":"BioMed Res Int"},{"key":"10.1016\/j.amjsurg.2025.116730_bib15","doi-asserted-by":"crossref","first-page":"e556","DOI":"10.1016\/j.jormas.2022.03.001","article-title":"Aspirin, heparin and ischemia time in microvascular free flap surgery - their influence and an optimal anticoagulation protocol","volume":"123","author":"Rothweiler","year":"2022","journal-title":"J Stomatol Oral Maxillofac Surg"},{"key":"10.1016\/j.amjsurg.2025.116730_bib16","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.jpra.2023.11.003","article-title":"Postoperative outcomes of aspirin in microvascular free tissue transfer surgery\u2014A systematic review and meta-analysis","volume":"39","author":"Khan","year":"2024","journal-title":"JPRAS Open"},{"key":"10.1016\/j.amjsurg.2025.116730_bib17","series-title":"Anticoagulation Therapy in Microsurgery: A Review","author":"Askari","year":"2006"},{"key":"10.1016\/j.amjsurg.2025.116730_bib18","doi-asserted-by":"crossref","DOI":"10.1016\/j.jormas.2024.101863","article-title":"Prophylaxis of microvascular thrombosis using direct oral anticoagulants (DOAC) in microvascular free tissue transplantation \u2013 a pilot study","volume":"125","author":"Bschorer","year":"2024","journal-title":"J Stomatol Oral Maxillofac Surg"},{"key":"10.1016\/j.amjsurg.2025.116730_bib19","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.anl.2023.08.001","article-title":"Enhanced recovery pathways for head and neck surgery with free tissue transfer reconstruction","volume":"51","author":"Imai","year":"2024","journal-title":"Auris Nasus Larynx"},{"key":"10.1016\/j.amjsurg.2025.116730_bib20","article-title":"Early mobilization of critically ill patients in the intensive care unit: a systematic review and meta-analysis","volume":"14","author":"Zhang","year":"2019","journal-title":"PLoS One"},{"key":"10.1016\/j.amjsurg.2025.116730_bib21","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.suronc.2020.04.025","article-title":"Enhanced recovery after surgery program involving preoperative dexamethasone administration for head and neck surgery with free tissue transfer reconstruction: single-center prospective observational study","volume":"34","author":"Imai","year":"2020","journal-title":"Surg Oncol"},{"key":"10.1016\/j.amjsurg.2025.116730_bib22","article-title":"Early initiation of dangle protocol in lower extremity free flap microsurgery","author":"Su","year":"2025","journal-title":"J Reconstr Microsurg"},{"key":"10.1016\/j.amjsurg.2025.116730_bib23","doi-asserted-by":"crossref","first-page":"2996","DOI":"10.1002\/lary.24241","article-title":"Delayed mobilization after microsurgical reconstruction: an independent risk factor for pneumonia","volume":"123","author":"Yeung","year":"2013","journal-title":"Laryngoscope"},{"key":"10.1016\/j.amjsurg.2025.116730_bib24","author":"Lima de Araujo","year":"2024","journal-title":"Ann Surg Oncol"},{"key":"10.1016\/j.amjsurg.2025.116730_bib25","article-title":"Impact of early mobilization on recovery after major head and neck surgery with free flap reconstruction","volume":"13","author":"Twomey","year":"2021","journal-title":"Cancers (Basel)"},{"key":"10.1016\/j.amjsurg.2025.116730_bib26","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/S0266-4356(02)00260-7","article-title":"Factors that influence the outcome of salvage in free tissue transfer","volume":"41","author":"Brown","year":"2003","journal-title":"Br J Oral Maxillofac Surg"},{"key":"10.1016\/j.amjsurg.2025.116730_bib27","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1097\/01.prs.0000260598.24376.e1","article-title":"Free flap reexploration: indications, treatment, and outcomes in 1193 free flaps","volume":"119","author":"Bui","year":"2007","journal-title":"Plast Reconstr Surg"}],"container-title":["The American Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002961025005537?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002961025005537?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T17:25:00Z","timestamp":1779297900000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0002961025005537"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":27,"alternative-id":["S0002961025005537"],"URL":"https:\/\/doi.org\/10.1016\/j.amjsurg.2025.116730","relation":{},"ISSN":["0002-9610"],"issn-type":[{"value":"0002-9610","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Strategies to minimize postoperative complications in microsurgical free tissue transfer: The role of anticoagulation, antiplatelets, and ambulation","name":"articletitle","label":"Article Title"},{"value":"The American Journal of Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.amjsurg.2025.116730","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"116730"}}