Safety of DIEP Flap Reconstruction in Patients with Factor V Leiden: A Retrospective Cohort Study.

18 In a prospective study evaluating 1600 patients from 12 European counties undergoing total hip or knee surgery wherein all patients were screened for FVL mutations and prothrombin gene mutations, the investigators found a nonsignificant trend toward increased risk of VTE in FVL patients. 17 These studies from other surgical specialties generally conclude that the best course of action to protect these patients from VTE includes a robust screening and perioperative anticoagulation protocol, with consultation of hematology if appropriate.

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Higher rates of intraoperative thromboses, postoperative thromboses, and flap loss were found in the control group but did not reach statistical significance and were within the range of expected outcomes in the literature. 15 , 16 There were no significant differences in postoperative VTE in the FVL group compared with the matched or unmatched control groups.

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