Fibrinogen-to-albumin ratio (FAR) for predicting microvascular flap complications in reconstructive surgery
Summary: Background: Microvascular flap surgery is a widely used procedure for the reconstruction of various defects. Data on laboratory biomarkers for the prediction of flap complications are currently limited. We aimed to investigate the link between preoperative fibrinogen-to-albumin ratio (FAR)...
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Elsevier
2025-06-01
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| Series: | JPRAS Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352587825000646 |
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| author | Rihards Peteris Rocans Janis Zarins Evita Bine Insana Mahauri Renars Deksnis Margarita Citovica Simona Donina Indulis Vanags Biruta Mamaja |
| author_facet | Rihards Peteris Rocans Janis Zarins Evita Bine Insana Mahauri Renars Deksnis Margarita Citovica Simona Donina Indulis Vanags Biruta Mamaja |
| author_sort | Rihards Peteris Rocans |
| collection | DOAJ |
| description | Summary: Background: Microvascular flap surgery is a widely used procedure for the reconstruction of various defects. Data on laboratory biomarkers for the prediction of flap complications are currently limited. We aimed to investigate the link between preoperative fibrinogen-to-albumin ratio (FAR) and various flap complications. Methods: This prospective cohort study included 130 adult patients who underwent elective microvascular flap surgery. Preoperative blood samples for the analysis of plasma fibrinogen (g/L) and albumin (g/L) were collected on the day of surgery before initiating crystalloid infusion. Post-operative data on various flap complications were obtained. Results: The overall complication rate was 17.7% with true flap loss occurring in 5.4%. Binary logistic regression revealed that the patients with FAR<0.08 and FAR<0.06 had increased odds of flap hematoma or flap loss (OR 3.68 [1.04-13.03], p=0.044 and 6.01 [1.71-21.08], p=0.005). Patients with FAR>0.10 had increased odds of minor flap complications (OR 5.47 [1.33-22.50], p=0.019). Patients with FAR<0.06 had increased odds of any flap complications (OR 4.71 [1.27-18.03], p=0.021). Patients with FAR>0.10 also had increased odds of any flap complications (OR 3.09 [1.08-8.81], p=0.035), implying a U-shaped link. Conclusions: Assessment of FAR to estimate the risk of complications has considerable predictive value in microvascular flap surgery. Patients undergoing this surgery can be evaluated to predict their nutrition and coagulation risks and optimize decision-making in their perioperative care. |
| format | Article |
| id | doaj-art-d02e4eaf14304db0b856104f73cd71a1 |
| institution | Kabale University |
| issn | 2352-5878 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JPRAS Open |
| spelling | doaj-art-d02e4eaf14304db0b856104f73cd71a12025-08-20T03:54:07ZengElsevierJPRAS Open2352-58782025-06-014441442310.1016/j.jpra.2025.03.022Fibrinogen-to-albumin ratio (FAR) for predicting microvascular flap complications in reconstructive surgeryRihards Peteris Rocans0Janis Zarins1Evita Bine2Insana Mahauri3Renars Deksnis4Margarita Citovica5Simona Donina6Indulis Vanags7Biruta Mamaja8Intensive Care Clinic, Riga East Clinical University Hospital, Riga, Latvia; Department of Anaesthesia and Intensive Care, Riga Stradiņš University, Riga, Latvia; Corresponding author.Department of Hand and Plastic Surgery, Microsurgery Centre of Latvia, Riga, Latvia; Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga, LatviaIntensive Care Clinic, Riga East Clinical University Hospital, Riga, LatviaDepartment of Anaesthesia and Intensive Care, Riga Stradiņš University, Riga, LatviaSurgical Oncology Clinic, Riga East Clinical University Hospital, Riga, LatviaLaboratory Department, Riga East Clinical University Hospital, Riga, LatviaInstitute of Microbiology and Virology, Riga Stradiņš University, Riga, Latvia; Outpatient Department, Riga East Clinical University Hospital, Riga, LatviaDepartment of Anaesthesia and Intensive Care, Riga Stradiņš University, Riga, LatviaDepartment of Anaesthesia and Intensive Care, Riga Stradiņš University, Riga, LatviaSummary: Background: Microvascular flap surgery is a widely used procedure for the reconstruction of various defects. Data on laboratory biomarkers for the prediction of flap complications are currently limited. We aimed to investigate the link between preoperative fibrinogen-to-albumin ratio (FAR) and various flap complications. Methods: This prospective cohort study included 130 adult patients who underwent elective microvascular flap surgery. Preoperative blood samples for the analysis of plasma fibrinogen (g/L) and albumin (g/L) were collected on the day of surgery before initiating crystalloid infusion. Post-operative data on various flap complications were obtained. Results: The overall complication rate was 17.7% with true flap loss occurring in 5.4%. Binary logistic regression revealed that the patients with FAR<0.08 and FAR<0.06 had increased odds of flap hematoma or flap loss (OR 3.68 [1.04-13.03], p=0.044 and 6.01 [1.71-21.08], p=0.005). Patients with FAR>0.10 had increased odds of minor flap complications (OR 5.47 [1.33-22.50], p=0.019). Patients with FAR<0.06 had increased odds of any flap complications (OR 4.71 [1.27-18.03], p=0.021). Patients with FAR>0.10 also had increased odds of any flap complications (OR 3.09 [1.08-8.81], p=0.035), implying a U-shaped link. Conclusions: Assessment of FAR to estimate the risk of complications has considerable predictive value in microvascular flap surgery. Patients undergoing this surgery can be evaluated to predict their nutrition and coagulation risks and optimize decision-making in their perioperative care.http://www.sciencedirect.com/science/article/pii/S2352587825000646fibrinogen-to-albumin ratioFARmicrovascular flap surgerymicrovascular flap complicationsreconstructive surgery |
| spellingShingle | Rihards Peteris Rocans Janis Zarins Evita Bine Insana Mahauri Renars Deksnis Margarita Citovica Simona Donina Indulis Vanags Biruta Mamaja Fibrinogen-to-albumin ratio (FAR) for predicting microvascular flap complications in reconstructive surgery JPRAS Open fibrinogen-to-albumin ratio FAR microvascular flap surgery microvascular flap complications reconstructive surgery |
| title | Fibrinogen-to-albumin ratio (FAR) for predicting microvascular flap complications in reconstructive surgery |
| title_full | Fibrinogen-to-albumin ratio (FAR) for predicting microvascular flap complications in reconstructive surgery |
| title_fullStr | Fibrinogen-to-albumin ratio (FAR) for predicting microvascular flap complications in reconstructive surgery |
| title_full_unstemmed | Fibrinogen-to-albumin ratio (FAR) for predicting microvascular flap complications in reconstructive surgery |
| title_short | Fibrinogen-to-albumin ratio (FAR) for predicting microvascular flap complications in reconstructive surgery |
| title_sort | fibrinogen to albumin ratio far for predicting microvascular flap complications in reconstructive surgery |
| topic | fibrinogen-to-albumin ratio FAR microvascular flap surgery microvascular flap complications reconstructive surgery |
| url | http://www.sciencedirect.com/science/article/pii/S2352587825000646 |
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