Researchers at the Keck School of Medicine of USC have found a way to identify patients who may be susceptible to certain complications while recovering from large wounds and complicated reconstructive surgeries. The team’s findings were published in August in the Public Library of Science’s online publication PLOS ONE.
The team, led by Alex Wong, assistant professor of clinical surgery at the Keck School, discovered five genetic biomarkers that can identify patients who could be susceptible to vein failure after receiving “flaps.” Flaps are tissues that are teeming with tiny blood vessels, which can be moved from one part of the body to another to help the healing process.
“We can transfer a piece of tissue with its own blood supply and sometimes even nerves,” Wong said. “What we’re doing is essentially a transplant.”
While nearly all such patients recover without incident, 5 to 8 percent will experience flap failure because their veins are prone to kinking and collapsing, Wong said.
The information is especially important as surgical procedures become more complicated and intricate.
“The nature of plastic surgery is to restore form and function,” Wong added. “By our reconstructions, we do everything from repairing wounds to face and hand transplants.”
While arteries that supply the blood are generally strong enough to handle the procedure, veins that carry it away are weaker and fail more easily. The biomarkers can alert physicians that a patient is at risk of vein failure, which can appear just a few hours after a procedure.
“If an artery goes down, the color of the tissue changes, the pulse disappears, and the transplanted tissue becomes cold,” Wong said. “By comparison, when a vein fails, it’s often not recognized until it’s too late to salvage.”
Though still in the early stages of investigation, Wong hopes to be able to identify patients before complications arise.
“If we prove our theory, we can create a routine test to maybe change that 5 percent failure rate to 1 percent,” Wong said. “And for the 4 percent of people who could potentially benefit, it could make a 100-percent difference.”