Free flap loss caused by heparin-induced thrombocytopenia and thrombosis (HITT): a case report and literature review.

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Free flap loss caused by heparin-induced thrombocytopenia and thrombosis (HITT): a case report and literature review.

Acta Otorhinolaryngol Ital. 2016 Dec;36(6):527-533

Authors: Segna E, Bolzoni AR, Baserga C, Baj A

Abstract
Heparin-induced thrombocytopenia and thrombosis (HITT) represents a dramatic condition that is difficult to diagnose because of nuanced clinical presentation. Therefore, in every case of microvascular thrombosis during heparin-therapy prompt suspicion about HITT is necessary to avoid flap necrosis. We present a case of HITT which, as the 8 other articles reviewed, clearly shows that HITT is difficult to diagnose and complex to manage. Microvascular reconstruction is the first choice in head and neck reconstruction; unfortunately, dramatic outcomes in free flap surgery due to unpredictable thrombotic events are still reported in the English literature. More knowledge is required about HITT and reaching a consensus about thrombotic prevention in microsurgery could be helpful. Furthermore, a careful anamnesis can help minimise unexpected situations.

PMID: 28177337 [PubMed - in process]

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