{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:13:40Z","timestamp":1773029620667,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,12,30]],"date-time":"2019-12-30T00:00:00Z","timestamp":1577664000000},"content-version":"vor","delay-in-days":363,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Surgery"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>Hemophilia is a blood disorder characterized by impairment of the coagulation cascade leading to an increased bleeding risk (Kauffman, 2014). As such, surgical management of these patients can become difficult and well\u2010defined surgical guidelines are not yet in place (Assoumane et al., 2017). Close monitoring of perioperative factor levels may be even more crucial for those undergoing microvascular free tissue transfer. This is because either a hypercoagulable or hypocoagulable bleeding state has the potential to further increase the risk of vascular compromise to the flap. We report a successful case of mandibular reconstruction using a free fibular flap in a patient with severe hemophilia B and the protocols we used, as well as a review of the literature of similar cases. In the literature, we identified 6 cases of microvascular free tissue transfer in patients with hemophilia; two of these cases had complications which were both related to excess bleeding. It is crucial that these cases be managed in a multidisciplinary fashion in close consultation with a hematologist. The role of venothromboembolism (VTE) prophylaxis in the hemophilic patient undergoing free tissue transfer is discussed.<\/jats:p>","DOI":"10.1155\/2019\/5430786","type":"journal-article","created":{"date-parts":[[2019,12,30]],"date-time":"2019-12-30T18:31:36Z","timestamp":1577730696000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Vascularized Free Tissue Transfer in a Patient with Hemophilia B: Case Report and Literature Review"],"prefix":"10.1155","volume":"2019","author":[{"given":"Mohammed","family":"Qaisi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5422-9909","authenticated-orcid":false,"given":"Justin","family":"Kierce","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Murphy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,30]]},"reference":[{"key":"e_1_2_5_1_2","doi-asserted-by":"publisher","DOI":"10.1097\/NAN.0000000000000023"},{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1615621"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13405-8"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2008.03.009"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2005.01.008"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2016.10.001"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1080530"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13279"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2005.11.024"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2008.01950.x"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009961.pub2"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2009.02.018"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.76.898.494"},{"key":"e_1_2_5_14_2","unstructured":"The Australian Haemophilia Centre Doctors Organisation Guidelines for the management of patients with haemophilia undergoing surgical procedures 2005 https:\/\/www.ahcdo.org.au\/publications\/cid\/1\/parent\/0\/t\/publications\/parent-name\/Guidelines."},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/1076029616643821"},{"key":"e_1_2_5_16_2","first-page":"336","article-title":"Hemophilia B and free tissue transfer: medical and surgical management","volume":"54","author":"Knott P. 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