Table 2. Clinical components of previously published head and neck free flap transfer cases and cases reported in this article.

Previously published reports		Time	Preoperative laboratories and medications		Intraoperative course/complications	Postoperative laboratories	Postoperative complications/course
Lin and Yu 4	Resection of mandible		Hgb—18.5 (15.9 a ) Hct—52.7%		No blood transfusions or anticoagulation EBL = 400 mL	Hgb—12 Hct—38%	No thrombotic events and flap survived. Received daily aspirin 81 mg and no other anticoagulation
Ghazali et al 5	Resection of mandible		Hgb—14.8 Hct—37.6%	Aspirin Hydroxyurea	No blood transfusions or anticoagulation was used	Hgb—9.7 Hct—30.6%	Transient sinus bradycardia, otherwise uneventful. Continued aspirin and hydroxyurea. Received daily subcutaneous LMWH
Current series
Case 1	Resection of mandible Flaps: 1. Right fibula flap (9 cm × 6 cm) to mandible 2. Right ALT flap (15 cm × 8 cm) to submental/central neck 3. Left pectoralis major (8 cm × 4 cm) to oral cavity and neck 4. STSG from left thigh (4 cm × 3 cm) to right lower extremity	34 d	Hgb—10.0 Hct—31% PLT—55,000 b PT—16.5 PTT—34.4	Aspirin Ruxolitinib	Received a total of 4 U of pRBCs, 6 L of crystalloid solution, 1.2 L of colloid solution EBL = 550 mL	Hgb—6.4 Hct—18.4% PLT—76,000 PT—19.7 PTT—57.9	Persistent anemia requiring five separate blood transfusions, right thigh hematoma at the ALT free flap donor site, poor wound healing leading to neck flap dehiscence requiring partial reconstruction and repair with pectoralis flap. Prolonged antibiotic therapy. No thrombosis or hemorrhage
Case 2	Resection of temporalis AVM Flap: Left anteromedial thigh flap (15 cm × 7 cm) to temple	56 d	Hgb—10.1 Hct—30.9% PLT—320,000 PT—15.1 PTT—57.8	Ruxolitinib Apixaban	Received 2.3 L of crystalloid, 250 mL of colloid solution, and 25 mg of ephedrine EBL = 250 mL	Hgb—9.3 Hct—27.9% PLT—292,000 PT—15.1 PTT—40.1	Left scalp and thigh hematomas requiring 1 U of pRBC transfusion, washout, and flap exploration. Aspirin 325 mg once after AVM embolization. Aspirin 81 mg on POD2 of flap
Case 3	Resection of mandible Flap: Supraclavicular locoregional flap (8 cm × 25 cm) to mandible	23 d	Hgb—9.4 Hct—29% PLT—1,185,000 c	Aspirin Hydroxyurea	Received 1.6 L of lactated ringers, 1 L of NS and 2 U of pRBCs EBL = 50 mL	Hgb—8.1 Hct—22.9% PLT—217,000	Received an additional 1 U of pRBC on POD2 due to a Hgb drop (6.9, from 8.1). Restarted enoxaparin 30 mg on POD1, aspirin 81 mg on POD2
Case 4	Resection of temporal bone, auricle, and parotid Flap: SCM, temporalis locoregional flap (5 cm × 6 cm) to temporal bone defect	92 d	Hgb—13.9 Hct—43% PLT—not reported	Aspirin Clopidogrel Enoxaparin	Received 1 L of albumin, 1 L of lactated ringers, 2 L of NS and 2 L of crystalloid solution	Hgb—12.6 Hct—36.4% PLT—218,000	81 mg starting on POD3. Apixaban was resumed on POD6

Abbreviations: ALT, anterolateral thigh; AVM, arteriovenous malformation; EBL, estimated blood loss; Hct, hematocrit; Hgb, hemoglobin (g/dL); LMWH, low-molecular-weight heparin; NS, normal saline; PLT, platelet (per μL); POD, postoperative day; pRBC, packed red blood cell; PT, prothombin time (second); PTT, partial thromboplastin time (second); SCM, sternocleidomastoid; STSG, split-thickness skin graft; U, unit.

Note: “Time” describes time from presentation to surgery.

^aPostphlebotomy.

^bPlatelet transfusion required.

^cMost recent available laboratory value obtained more than 2 weeks prior to surgery.