D121. Impact of Covid-19 on Thrombotic Complications in Microsurgery

PURPOSE: Studies have demonstrated an increased risk of vasculitis and microvascular thrombi in patients with COVID-19. While the creation of the SARS-CoV-2 vaccine was instrumental in the management of the pandemic, there are similar concerns regarding pro-thrombotic events. Following the end of the COVID-19 pandemic, we sought to analyze the impact of this infection on microsurgery as anecdotal and scientific evidence would suggest an increased rate of thrombosis. METHODS: An IRB review was conducted of women undergoing autologous breast reconstruction between January 2019 and March 2022. Patients were divided into 3 cohorts based on date of surgery and history of infection or vaccine. Statistical analysis was performed. RESULTS: 216 patients had surgery prior to the start of the COVID pandemic and 311 patients had surgery during the pandemic. There was a 3.2% incidence of thrombotic events (VTE or flap compromise) prior to the pandemic and a 6.4% incidence during the pandemic. Patients operated on during the pandemic were further subdivided based on prior covid infection or vaccine. There was no statistically significant difference between groups. CONCLUSION: Microsurgeons seek to mitigate thrombotic risk in their patient population and previously little was known about the specific impact of COVID-19 on microsurgical outcomes. Based on our analysis, COVID-19 does not significantly increase the rates of thrombotic events (flap compromise or VTE) in DIEP flap breast reconstruction.