{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T16:26:03Z","timestamp":1778862363642,"version":"3.51.4"},"reference-count":8,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,4,17]]},"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:p>Although sickle cell disease has long been viewed as a contraindication to free flap transfer, little data exist evaluating complications of microsurgical procedures in the sickle cell trait patient. Reported is the case of a 55-year-old woman with sickle cell trait who underwent a deep inferior epigastric perforator microvascular free flap following mastectomy. The flap developed signs of venous congestion on postoperative day 2 but was found to have patent arterial and venous anastomoses on exploration in the operating room. On near-infrared indocyanine green angiography, poor vascular flow was noted despite patent anastomoses and strong cutaneous arterial Doppler signals. Intrinsic microvascular compromise or sickling remains a risk in the sickle cell trait population as it does for the sickle cell disease population. Just like in sickle cell disease patients, special care should be taken to optimise anticoagulation and minimise ischaemia-induced sickling for patients with sickle cell trait undergoing microsurgery.<\/jats:p>","DOI":"10.1136\/bcr-2020-234924","type":"journal-article","created":{"date-parts":[[2020,5,7]],"date-time":"2020-05-07T06:49:28Z","timestamp":1588834168000},"page":"e234924","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Microsurgery in the sickle cell trait population: is it actually safe?"],"prefix":"10.1136","volume":"13","author":[{"given":"Paul F","family":"Abraham","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Allam","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kitae Eric","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Alperovich","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,5,6]]},"reference":[{"key":"2025082713010428000_13.5.e234924.1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.bjps.2016.10.005","article-title":"Free tissue transfer in patients with sickle cell disease: considerations for multi-disciplinary peri-operative management","volume":"70","author":"Cooper","year":"2017","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"2025082713010428000_13.5.e234924.2","doi-asserted-by":"publisher","DOI":"10.1100\/tsw.2008.157"},{"key":"2025082713010428000_13.5.e234924.3","article-title":"Incidence of sickle cell trait--United States, 2010","volume":"63","author":"Ojodu","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025082713010428000_13.5.e234924.4","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000072283.47341.43"},{"key":"2025082713010428000_13.5.e234924.5","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1002\/micr.22024","article-title":"Intra-flap thrombosis secondary to acute sickle crisis: a case report","volume":"32","author":"McAnneny","year":"2012","journal-title":"Microsurgery"},{"key":"2025082713010428000_13.5.e234924.6","first-page":"516","article-title":"Exchange transfusion for flap surgery in sickle cell anemia","volume":"23","author":"Ashbell","year":"1972","journal-title":"Surg Forum"},{"key":"2025082713010428000_13.5.e234924.7","doi-asserted-by":"crossref","first-page":"723e","DOI":"10.1097\/PRS.0000000000001676","article-title":"Free tissue transfer in patients with sickle cell trait: not just a trait","volume":"136","author":"Han","year":"2015","journal-title":"Plast Reconstr Surg"},{"key":"2025082713010428000_13.5.e234924.8","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1054\/bjps.2000.3446","article-title":"Successful free flap transfer and salvage in sickle cell trait","volume":"53","author":"Platt","year":"2000","journal-title":"Br J Plast Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-234924","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:01:13Z","timestamp":1756324873000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-234924"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5]]},"references-count":8,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,5,6]]},"published-print":{"date-parts":[[2020,5]]}},"alternative-id":["10.1136\/bcr-2020-234924"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-234924","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5]]}}}