Archives of Plastic Surgery

  • 제52권3호
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  • Pages.197-201
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  • 2025
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
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Clinical Significance of Hyperhomocysteinemia in Free Flap Failure: A Case Report

  • Abeje Brhanu Menjeta (Division of Plastic and Reconstructive Surgery, Department of Surgery, St. Paul's Hospital Millennium Medical College) ;
  • Hyung Hwa Jeong (Department of Plastic and Reconstructive Surgery, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Tae Hyung Kim (Department of Plastic and Reconstructive Surgery, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Seongsu Jeong (Department of Plastic and Reconstructive Surgery, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Changsik John Pak (Department of Plastic and Reconstructive Surgery, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Hyunsuk Peter Suh (Department of Plastic and Reconstructive Surgery, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Joon Pio Hong (Division of Plastic and Reconstructive Surgery, Department of Surgery, St. Paul's Hospital Millennium Medical College)
  • 투고 : 2023.06.10
  • 심사 : 2024.05.28
  • 발행 : 2025.05.15
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초록

Failure of a microvascular free flap remains rare, yet multiple failures can occur, particularly in the presence of hypercoagulable conditions. This case series highlights our experience with a rare hypercoagulable state: hyperhomocysteinemia. We present two cases of patients with hyperhomocysteinemia in this report. High-dose heparinization was administered to both patients, resulting in successful salvage of one flap and failure of the other. Notably, one patient had a history of prior free flap failures. However, after correcting hyperhomocysteinemia, subsequent free flaps were successful. In cases of detected complications, a coagulability study is warranted, and adjustments to anticoagulation treatment may be necessary. Furthermore, when a history of flap failures is evident, screening for hyperhomocysteinemia may be warranted, with correction made prior to reconstruction.

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참고문헌

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