About

Jayant Agarwal, MD, is a professor at the University of Utah Health with clinical interests that include aesthetic plastic surgery, hand surgery, and reconstructive microsurgery. He emphasizes using perforator flaps, a cutting-edge technique that uses the patient's own tissues to reconstruct the breast, head and neck, and extremities. Dr. Agarwal started the first Breast Reconstruction Fellowship training program at the University of Utah and serves as its Program Director. He also advises medical students seeking to match into competitive residency programs. His specialties encompass microsurgery, plastic surgery, wound healing, flap surgery, trunk and extremity reconstruction, head and neck reconstruction, pediatric plastic surgery, and various aspects of breast surgery, including reconstruction and cancer surgery. He is board-certified by the National Board of Medical Examiners and is highly rated by patients for his compassionate care, clear communication, and surgical expertise.

Research topics

• Internal medicine
• Medicine
• Surgery
• Anesthesia
• Gerontology
• Demography
• Environmental health

Selected publications

• Suzetrigine As A Novel Non-opioid Analgesic: Reducing Postoperative Opioid Consumption In Autologous Breast Reconstruction

  Zenodo (CERN European Organization for Nuclear Research) · 2026-05-10

  articleOpen access

  PURPOSE: Postoperative opioid use remains high across surgical populations and contributes significantly to dependence, particularly among opioid-nave patients. Autologous breast reconstruction is associated with substantial postoperative pain, with 6-10% of patients developing opioid dependence following surgery. This highlights the need for effective non-opioid analgesics within multimodal pain regimens. Suzetrigine, a novel peripherally selective sodium channel blocker recently approved by the FDA for acute pain, acts by inhibiting voltage-gated sodium channels in peripheral sensory neurons, reducing pain signaling with minimal side effects that are common with opioid pain medications. The role of suzetrigine in autologous breast reconstruction has not been studied. Given the high pain burden in this population, this study aims to compare postoperative opioid requirements in patients receiving perioperative suzetrigine versus controls undergoing DIEP flap breast reconstruction. METHODS: Patients who underwent DIEP flap reconstruction were reviewed to identify two consecutive cohorts of 10 patients each: a control group without suzetrigine exposure (November-December 2023) and a study group with perioperative suzetrigine administration (July-October 2025). Patients treated in the intervening period were excluded due to intraoperative methadone use, which could confound postoperative opioid consumption. Data collected included patient demographics, operative details, hospital length of stay (LOS), postoperative complications, and postoperative opioid use per patient. The primary outcome was daily and total postoperative opioid requirements, recorded in oral morphine milligram equivalents (MME). RESULTS: Postoperative opioid consumption, expressed as total MME per patient, was significantly reduced in the suzetrigine group across the postoperative period. On postoperative day (POD) 0, mean opioid consumption was similar between groups (32.0 20.5 MME vs. 26.1 18.0 MME; p = 0.50). By POD 1, patients receiving suzetrigine required markedly fewer opioids compared to controls (22.2 25.7 MME vs. 65.6 38.2 MME; p = 0.008), representing a greater than 65% reduction in postoperative opioid use. This significant difference persisted through POD 2 (17.7 16.4 MME vs. 49.3 34.6 MME; p = 0.021), reflecting a greater than 60% reduction. Cumulatively, total opioid consumption across the entire inpatient stay was more than 50% lower among suzetrigine recipients (69.1 53.0 MME) compared to controls (169.3 101.7 MME; p = 0.015). No major complications were observed in the suzetrigine group. CONCLUSIONS: In this early clinical experience, perioperative administration of suzetrigine, a novel non-opioid sodium channel blocker, in patients undergoing DIEP flap reconstruction was associated with a greater than 50% reduction in postoperative opioid consumption without compromising pain control or safety. These findings underscore suzetrigines potential as an effective adjunct within multimodal analgesia regimens. Given the ongoing opioid epidemic, this marked reduction in opioid requirements represents a meaningful step toward reducing postoperative opioid use. While limited by small sample size and retrospective design, our study provides compelling preliminary evidence supporting suzetrigines clinical utility. Larger, prospective trials are warranted to validate these results and further define its role in opioid-sparing postoperative care.© 2026. Plastic Surgery Research Council | All rights reserved |*Source: https://ps-rc.org/meeting/Program/2026/AS111.cgi*

  PublisherDOI

• Abdominoplasty With Or Without Liposuction: A National Comparison Of Postoperative Complication Risks

  Zenodo (CERN European Organization for Nuclear Research) · 2026-05-08

  articleOpen accessSenior author

  PURPOSE: Abdominoplasty and suction-assisted lipectomy (liposuction) are elective cosmetic procedures that may be performed on their own or together within a single surgical encounter. There is disagreement in the field over whether combining them into a single surgery increases the risk of surgical complications. Prior preliminary studies have suggested that combined abdominoplasty and liposuction surgeries were associated with fewer complications than abdominoplasty without liposuction. Here, we offer a more detailed comparison of the risk profiles associated with these two surgical options. METHODS: We conducted a retrospective cohort study using the TriNetX Research Networka global federated database of de-identified electronic health records. Adult patients (≥18 years) who underwent abdominoplasty between 2005 and 2025 were identified. These patients were stratified into two cohortsthose who underwent liposuction at the time of their abdominoplasty, and those who underwent abdominoplasty without liposuction. These two cohorts underwent 1:1 propensity score matching for age, sex, and body mass index (BMI). Our primary outcomes of interest included postprocedural hemorrhage/hematoma, postoperative seroma, deep venous thrombosis (DVT)/pulmonary embolism (PE), wound disruption/dehiscence, postoperative infection, and overall postoperative complication risk within 30 days of the procedure. RESULTS: A total of 17,961 patients who underwent abdominoplasty were identified4,781 who underwent abdominoplasty with liposuction, and 13,180 who underwent abdominoplasty without liposuction. Propensity score matching yielded 4,781 matched pairs that were used for subsequent analyses. The overall postoperative complication risk was significantly lower in the combined abdominoplasty and liposuction cohort (5.10% vs. 7.91%; risk ratio [RR] 0.65; p<0.0001). In particular, the risk of postprocedural hemorrhage/hematoma formation was significantly lower in the combined surgery cohort (0.75% vs. 1.40%; RR 0.47; p=0.002), as was the risk of postoperative seroma formation (0.38% vs. 1.13%; RR 0.33; p<0.0001) and surgical wound disruption/dehiscence (1.13% vs. 2.38%; RR 0.47; p<0.0001). The risk of postoperative infection was also significantly lower in the combined surgery cohort (1.84% vs. 2.57%; RR 0.72; p=0.015). There was no significant difference in the risk of DVT/PE between the two cohorts. CONCLUSION: Combined abdominoplasty with liposuction was not associated with increased risk of postoperative complications compared to abdominoplasty without liposuction. Interestingly, the combined surgery was associated with significantly lower risk of postoperative complicationsincluding hematoma/seroma formation, hemorrhage of skin/subcutaneous tissue, wound disruption/dehiscence, and infection. These conclusions have important implications in the realm of cosmetic surgery and could play an important role in the preoperative shared decision-making process.© 2026. Plastic Surgery Research Council | All rights reserved |*Source: https://ps-rc.org/meeting/Program/2026/99.cgi*

  PublisherDOI

• Perioperative Prophylactic Antibiotics and Endoscopic Carpal Tunnel Release

  Annals of Plastic Surgery · 2026-05-06

  articleSenior author

  PURPOSE: Carpal tunnel release (CTR) represents 90% of all surgically treated compression neuropathies, with around 500,000 procedures performed annually in the United States. Of these, roughly 25% are done endoscopically. Surgical site infections (SSIs) after CTR are rare, occurring in up to 1% of patients. Guidelines from the American Academy of Orthopaedic Surgeons (AAOS) and the American Association of Plastic Surgeons (AAPS) do not recommend perioperative prophylactic antibiotics for SSI prevention in CTR. Despite these guidelines, perioperative prophylactic antibiotics are still regularly used in CTR patients. Although the current guidelines are based upon a broad body of evidence, some of the current literature is limited by small cohort sizes, which highlights the need for further evaluation of this topic. Given this population's size, evaluating the necessity of perioperative prophylactic antibiotics is important for reducing antimicrobial resistance, lowering health care costs, and preventing antibiotic-associated adverse events. This study's aim is to compare the risk of SSIs after endoscopic CTR in large cohorts of patients who did and did not receive perioperative prophylactic antibiotics. METHODS: A retrospective cohort study was conducted using the TriNetX Research Network. The cohorts contained adult patients who underwent endoscopic CTR with or without perioperative antibiotic exposure. Cohorts were then 1:1 propensity-matched, and measures of association analyses were run that calculated and compared the cohorts' risk of SSI in the thirty days postoperatively. RESULTS: There was no statistically significant difference in superficial SSI risk between the cohorts with and without perioperative antibiotic prophylaxis (risk difference=0, 95% CI=0, 0, Z=0.47, P =0.638). CONCLUSIONS: Consistent with current AAPS and AAOS clinical guidelines, there is no increased risk of superficial SSIs for individuals who do not receive perioperative prophylactic antibiotics for endoscopic CTR.

  PublisherDOI

• Timing Matters: Risk Factors And Outcomes Of Late Tissue Expander Infections

  Zenodo (CERN European Organization for Nuclear Research) · 2026-05-10

  articleOpen accessSenior author

  PURPOSE: Tissue expander (TE) reconstruction is common after mastectomy, yet infectious complications remain a significant challenge. Reported postoperative infection rates range from 2.5-3.4%, but most studies focus only on the immediate 30-day period. Late tissue expander (TE) infectionsoccurring beyond 30 daysare underreported despite their potential to disrupt reconstruction, delay oncologic therapy, and necessitate explantation. This study aimed to describe the incidence of late infections (>30 days) and to identify clinical and operative risk factors for infection between early (≤30 days) and late (>30 days) infections. METHODS: We performed a retrospective chart review of patients who underwent tissue expander (TE)-based breast reconstruction between January 2018 and May 2025. Inclusion criteria required ≥3 months of follow-up and completion of the reconstructive journey (expander to definitive reconstruction). Collected demographic variables included age, sex, BMI, race/ethnicity, smoking history, and diabetes status. Surgical variables included mastectomy type, lymph node surgery, mastectomy specimen weight, TE pocket location (prepectoral vs. subpectoral), and acellular dermal matrix use. Postoperative outcomes included hematoma, seroma, wound dehiscence, surgical debridement, and infection. For infected cases, infection timing (≤30 vs. >30 days), management strategy, antibiotic use, culture results, and downstream reconstructive outcomes were recorded. Univariate logistic regression models were used to identify variables associated with infection and multivariate regression was used to determine independent predictors after adjusting for confounding factors. RESULTS: A total of 1,169 breasts from 722 patients were identified. Overall, 142 breasts (12.1%) developed an infection. 107 infections (75%) occurred late (>30 days) and 35 (25%) occurred early (≤30 days). The mean time to infection was 61 days after TE placement. On multivariate analysis after controlling for BMI, diabetes, smoking status, radiotherapy, chemotherapy, ADM use, TE plan placement, and mastectomy weight, only history of axillary dissection was associated with an increased risk for TE infection (21.9% vs. 11.7%, p=0.003). After controlling for the same confounders, early infections were found to be associated with ADM use (60% vs. 40%, p=0.020). CONCLUSION: Most TE infections occur outside the conventional 30-day postoperative period. A history of axillary dissection was associated with postoperative infection and early infections were associated with ADM use. These findings suggest that the conventional 30-day window is not an adequate quality measure when examining TE outcomes.© 2026. Plastic Surgery Research Council | All rights reserved |*Source: https://ps-rc.org/meeting/Program/2026/AS103.cgi*

  PublisherDOI

• Aspirin After Free Flaps: Does The Addition Of Postoperative Aspirin To Heparin-based Thromboprophylaxis Provide Any Meaningful Benefit?

  Zenodo (CERN European Organization for Nuclear Research) · 2026-05-08

  articleOpen access

  PURPOSE: Short-term thromboprophylaxis (unfractionated heparin [UFH] and low-molecular-weight heparin [LMWH]) is the standard of care for postoperative patients. Patients undergoing free flap reconstruction procedures are also often given aspirin to mitigate the risk of venous congestion and subsequent flap loss. No standardized recommendations exist regarding the use of both aspirin and UFH/LMWH. This study compares postoperative complication rates among free flap patients who received postoperative LMWH/UFH alone versus those who also received postoperative aspirin. METHODS: We conducted a retrospective cohort analysis using the TriNetX Research Networka global federated database of de-identified electronic health records. Adult patients (≥18 years) who underwent free flap procedures between 2005 and 2025 were identified using CPT codes. CPT codes with less than 100 entries were excluded from our analyses. These patients were stratified into two cohortsthose who received both LMWH/UFH and aspirin in the first 7 days after their procedure, and those who received LMWH/UFH only. These two cohorts underwent 1:1 propensity score matching for age, sex, body mass index (BMI), nicotine dependence, tobacco use, preoperative anticoagulant use, and preoperative antiplatelet use. Our postoperative outcomes included DVT/PE, hemorrhage/hematoma formation, wound dehiscence, revision of anastomosis, need for incision and drainage (I&D), and overall complication risk within 30 days of the procedure. RESULTS: A total of 26,928 patients who underwent free flap procedures were identified18,154 who received both aspirin and LMWH/UFH postoperatively, and 8,774 who received only LMWH/UFH. Propensity score matching yielded 8,351 matched pairs, which were used for subsequent analyses. The risk of having a DVT/PE within thirty days of the initial procedure was lower in the aspirin cohort (2.7% vs. 3.6%; risk ratio [RR] 0.76; p<0.01). However, the risk of postoperative hemorrhage/hematoma formation was significantly higher in the aspirin cohort (3.7% vs. 2.8%; RR 1.33; p=0.001), as was the risk of wound dehiscence (8.5% vs. 6.9%; p<0.01). The risk of requiring anastomotic revision within thirty days was also higher in the aspirin cohort (2.7% vs. 2.1%; RR 1.26; p=0.02). There was no significant difference in risk for requiring I&D between the two cohorts. Taken together, there was no significant difference in overall risk for postoperative complications between the two cohorts. CONCLUSION: In the setting of free flap reconstruction procedures, postoperative thromboprophylaxis with aspirin in combination with LMWH/UFH was associated with a lower risk of DVT/PE, but an increased risk for postoperative hemorrhage/hematoma formation, wound dehiscence, and need for anastomotic revision compared to LMWH/UFH therapy alone. In addition, the overall risk for postoperative complications was not significantly different between these two groups. This preliminary retrospective data suggests that while DVT/PE prevention was improved with the addition of aspirin to heparin-based thromboprophylaxis, the addition of aspirin may even increase some postoperative risks. Further prospective studies are needed to validate these conclusions and inform postoperative management of patients undergoing reconstruction with free flaps. *Source: https://ps-rc.org/meeting/Program/2026/MS22.cgi*

  PublisherDOI

• Suzetrigine As A Novel Non-opioid Analgesic: Reducing Postoperative Opioid Consumption In Autologous Breast Reconstruction

  Zenodo (CERN European Organization for Nuclear Research) · 2026-05-08

  articleOpen access

  PURPOSE: Postoperative opioid use remains high across surgical populations and contributes significantly to dependence, particularly among opioid-nave patients. Autologous breast reconstruction is associated with substantial postoperative pain, with 6-10% of patients developing opioid dependence following surgery. This highlights the need for effective non-opioid analgesics within multimodal pain regimens. Suzetrigine, a novel peripherally selective sodium channel blocker recently approved by the FDA for acute pain, acts by inhibiting voltage-gated sodium channels in peripheral sensory neurons, reducing pain signaling with minimal side effects that are common with opioid pain medications. The role of suzetrigine in autologous breast reconstruction has not been studied. Given the high pain burden in this population, this study aims to compare postoperative opioid requirements in patients receiving perioperative suzetrigine versus controls undergoing DIEP flap breast reconstruction. METHODS: Patients who underwent DIEP flap reconstruction were reviewed to identify two consecutive cohorts of 10 patients each: a control group without suzetrigine exposure (November-December 2023) and a study group with perioperative suzetrigine administration (July-October 2025). Patients treated in the intervening period were excluded due to intraoperative methadone use, which could confound postoperative opioid consumption. Data collected included patient demographics, operative details, hospital length of stay (LOS), postoperative complications, and postoperative opioid use per patient. The primary outcome was daily and total postoperative opioid requirements, recorded in oral morphine milligram equivalents (MME). RESULTS: Postoperative opioid consumption, expressed as total MME per patient, was significantly reduced in the suzetrigine group across the postoperative period. On postoperative day (POD) 0, mean opioid consumption was similar between groups (32.0 20.5 MME vs. 26.1 18.0 MME; p = 0.50). By POD 1, patients receiving suzetrigine required markedly fewer opioids compared to controls (22.2 25.7 MME vs. 65.6 38.2 MME; p = 0.008), representing a greater than 65% reduction in postoperative opioid use. This significant difference persisted through POD 2 (17.7 16.4 MME vs. 49.3 34.6 MME; p = 0.021), reflecting a greater than 60% reduction. Cumulatively, total opioid consumption across the entire inpatient stay was more than 50% lower among suzetrigine recipients (69.1 53.0 MME) compared to controls (169.3 101.7 MME; p = 0.015). No major complications were observed in the suzetrigine group. CONCLUSIONS: In this early clinical experience, perioperative administration of suzetrigine, a novel non-opioid sodium channel blocker, in patients undergoing DIEP flap reconstruction was associated with a greater than 50% reduction in postoperative opioid consumption without compromising pain control or safety. These findings underscore suzetrigines potential as an effective adjunct within multimodal analgesia regimens. Given the ongoing opioid epidemic, this marked reduction in opioid requirements represents a meaningful step toward reducing postoperative opioid use. While limited by small sample size and retrospective design, our study provides compelling preliminary evidence supporting suzetrigines clinical utility. Larger, prospective trials are warranted to validate these results and further define its role in opioid-sparing postoperative care.© 2026. Plastic Surgery Research Council | All rights reserved |*Source: https://ps-rc.org/meeting/Program/2026/AS111.cgi*

  PublisherDOI

• Sintering Improves the Mechanical Properties of Fluorapatite Scaffolds With Open Porous Gyroid Architecture

  International Journal of Applied Ceramic Technology · 2026-04-01

  articleOpen access

  ABSTRACT Synthetic scaffolds are needed to overcome the limitations of autografts and allografts for the treatment of critical‐sized bone defects. However, fabricating scaffolds with both high porosity and adequate mechanical stability for load‐bearing applications is difficult. This study was therefore undertaken to optimize the strength of fluorapatite (FAp) bone scaffolds. Here, we fabricated FAp scaffolds with a gyroid architecture—selected for its interconnected porosity and surface properties conducive to bone formation. Scaffolds with 50%, 60%, or 70% porosity were prepared by gel‐casting FAp suspensions within combustible 3D‐printed templates, followed by sintering at 1050°C, 1150°C, or 1250°C. Densification accelerated between 1050°C and 1150°C and slowed toward 1250°C, coinciding with reduced microporosity and increased shrinkage and strength. Scaffolds showed 44%–70% porosity and cancellous‐bone‐like compressive strengths (5–13 MPa). Strength and modulus increased with sintering temperature, most notably between 1050°C and 1150°C. SEM imaging revealed a distinct microporous core and surface layer (“skin”), and delamination of this layer suggested opportunities for process optimization. Together with prior in vitro and in vivo evidence of FAp's bone‐regenerative potential, these findings support the suitability of this fabrication approach for future translational studies and subsequent clinical applications.

  PublisherDOI

• Suzetrigine As A Novel Non-opioid Analgesic: Reducing Postoperative Opioid Consumption In Autologous Breast Reconstruction

  Zenodo (CERN European Organization for Nuclear Research) · 2026-05-10

  articleOpen accessSenior author

  PURPOSE: Postoperative opioid use remains high across surgical populations and contributes significantly to dependence, particularly among opioid-nave patients. Autologous breast reconstruction is associated with substantial postoperative pain, with 6-10% of patients developing opioid dependence following surgery. This highlights the need for effective non-opioid analgesics within multimodal pain regimens. Suzetrigine, a novel peripherally selective sodium channel blocker recently approved by the FDA for acute pain, acts by inhibiting voltage-gated sodium channels in peripheral sensory neurons, reducing pain signaling with minimal side effects that are common with opioid pain medications. The role of suzetrigine in autologous breast reconstruction has not been studied. Given the high pain burden in this population, this study aims to compare postoperative opioid requirements in patients receiving perioperative suzetrigine versus controls undergoing DIEP flap breast reconstruction. METHODS: Patients who underwent DIEP flap reconstruction were reviewed to identify two consecutive cohorts of 10 patients each: a control group without suzetrigine exposure (November-December 2023) and a study group with perioperative suzetrigine administration (July-October 2025). Patients treated in the intervening period were excluded due to intraoperative methadone use, which could confound postoperative opioid consumption. Data collected included patient demographics, operative details, hospital length of stay (LOS), postoperative complications, and postoperative opioid use per patient. The primary outcome was daily and total postoperative opioid requirements, recorded in oral morphine milligram equivalents (MME). RESULTS: Postoperative opioid consumption, expressed as total MME per patient, was significantly reduced in the suzetrigine group across the postoperative period. On postoperative day (POD) 0, mean opioid consumption was similar between groups (32.0 20.5 MME vs. 26.1 18.0 MME; p = 0.50). By POD 1, patients receiving suzetrigine required markedly fewer opioids compared to controls (22.2 25.7 MME vs. 65.6 38.2 MME; p = 0.008), representing a greater than 65% reduction in postoperative opioid use. This significant difference persisted through POD 2 (17.7 16.4 MME vs. 49.3 34.6 MME; p = 0.021), reflecting a greater than 60% reduction. Cumulatively, total opioid consumption across the entire inpatient stay was more than 50% lower among suzetrigine recipients (69.1 53.0 MME) compared to controls (169.3 101.7 MME; p = 0.015). No major complications were observed in the suzetrigine group. CONCLUSIONS: In this early clinical experience, perioperative administration of suzetrigine, a novel non-opioid sodium channel blocker, in patients undergoing DIEP flap reconstruction was associated with a greater than 50% reduction in postoperative opioid consumption without compromising pain control or safety. These findings underscore suzetrigines potential as an effective adjunct within multimodal analgesia regimens. Given the ongoing opioid epidemic, this marked reduction in opioid requirements represents a meaningful step toward reducing postoperative opioid use. While limited by small sample size and retrospective design, our study provides compelling preliminary evidence supporting suzetrigines clinical utility. Larger, prospective trials are warranted to validate these results and further define its role in opioid-sparing postoperative care.© 2026. Plastic Surgery Research Council | All rights reserved |*Source: https://ps-rc.org/meeting/Program/2026/AS111.cgi*

  PublisherDOI

• Timing Matters: Risk Factors And Outcomes Of Late Tissue Expander Infections

  Zenodo (CERN European Organization for Nuclear Research) · 2026-05-08

  articleOpen access

  PURPOSE: Tissue expander (TE) reconstruction is common after mastectomy, yet infectious complications remain a significant challenge. Reported postoperative infection rates range from 2.5-3.4%, but most studies focus only on the immediate 30-day period. Late tissue expander (TE) infectionsoccurring beyond 30 daysare underreported despite their potential to disrupt reconstruction, delay oncologic therapy, and necessitate explantation. This study aimed to describe the incidence of late infections (>30 days) and to identify clinical and operative risk factors for infection between early (≤30 days) and late (>30 days) infections. METHODS: We performed a retrospective chart review of patients who underwent tissue expander (TE)-based breast reconstruction between January 2018 and May 2025. Inclusion criteria required ≥3 months of follow-up and completion of the reconstructive journey (expander to definitive reconstruction). Collected demographic variables included age, sex, BMI, race/ethnicity, smoking history, and diabetes status. Surgical variables included mastectomy type, lymph node surgery, mastectomy specimen weight, TE pocket location (prepectoral vs. subpectoral), and acellular dermal matrix use. Postoperative outcomes included hematoma, seroma, wound dehiscence, surgical debridement, and infection. For infected cases, infection timing (≤30 vs. >30 days), management strategy, antibiotic use, culture results, and downstream reconstructive outcomes were recorded. Univariate logistic regression models were used to identify variables associated with infection and multivariate regression was used to determine independent predictors after adjusting for confounding factors. RESULTS: A total of 1,169 breasts from 722 patients were identified. Overall, 142 breasts (12.1%) developed an infection. 107 infections (75%) occurred late (>30 days) and 35 (25%) occurred early (≤30 days). The mean time to infection was 61 days after TE placement. On multivariate analysis after controlling for BMI, diabetes, smoking status, radiotherapy, chemotherapy, ADM use, TE plan placement, and mastectomy weight, only history of axillary dissection was associated with an increased risk for TE infection (21.9% vs. 11.7%, p=0.003). After controlling for the same confounders, early infections were found to be associated with ADM use (60% vs. 40%, p=0.020). CONCLUSION: Most TE infections occur outside the conventional 30-day postoperative period. A history of axillary dissection was associated with postoperative infection and early infections were associated with ADM use. These findings suggest that the conventional 30-day window is not an adequate quality measure when examining TE outcomes.© 2026. Plastic Surgery Research Council | All rights reserved |*Source: https://ps-rc.org/meeting/Program/2026/AS103.cgi*

  PublisherDOI

• Aspirin After Free Flaps: Does The Addition Of Postoperative Aspirin To Heparin-based Thromboprophylaxis Provide Any Meaningful Benefit?

  Zenodo (CERN European Organization for Nuclear Research) · 2026-05-08

  articleOpen access

  PURPOSE: Short-term thromboprophylaxis (unfractionated heparin [UFH] and low-molecular-weight heparin [LMWH]) is the standard of care for postoperative patients. Patients undergoing free flap reconstruction procedures are also often given aspirin to mitigate the risk of venous congestion and subsequent flap loss. No standardized recommendations exist regarding the use of both aspirin and UFH/LMWH. This study compares postoperative complication rates among free flap patients who received postoperative LMWH/UFH alone versus those who also received postoperative aspirin. METHODS: We conducted a retrospective cohort analysis using the TriNetX Research Networka global federated database of de-identified electronic health records. Adult patients (≥18 years) who underwent free flap procedures between 2005 and 2025 were identified using CPT codes. CPT codes with less than 100 entries were excluded from our analyses. These patients were stratified into two cohortsthose who received both LMWH/UFH and aspirin in the first 7 days after their procedure, and those who received LMWH/UFH only. These two cohorts underwent 1:1 propensity score matching for age, sex, body mass index (BMI), nicotine dependence, tobacco use, preoperative anticoagulant use, and preoperative antiplatelet use. Our postoperative outcomes included DVT/PE, hemorrhage/hematoma formation, wound dehiscence, revision of anastomosis, need for incision and drainage (I&D), and overall complication risk within 30 days of the procedure. RESULTS: A total of 26,928 patients who underwent free flap procedures were identified18,154 who received both aspirin and LMWH/UFH postoperatively, and 8,774 who received only LMWH/UFH. Propensity score matching yielded 8,351 matched pairs, which were used for subsequent analyses. The risk of having a DVT/PE within thirty days of the initial procedure was lower in the aspirin cohort (2.7% vs. 3.6%; risk ratio [RR] 0.76; p<0.01). However, the risk of postoperative hemorrhage/hematoma formation was significantly higher in the aspirin cohort (3.7% vs. 2.8%; RR 1.33; p=0.001), as was the risk of wound dehiscence (8.5% vs. 6.9%; p<0.01). The risk of requiring anastomotic revision within thirty days was also higher in the aspirin cohort (2.7% vs. 2.1%; RR 1.26; p=0.02). There was no significant difference in risk for requiring I&D between the two cohorts. Taken together, there was no significant difference in overall risk for postoperative complications between the two cohorts. CONCLUSION: In the setting of free flap reconstruction procedures, postoperative thromboprophylaxis with aspirin in combination with LMWH/UFH was associated with a lower risk of DVT/PE, but an increased risk for postoperative hemorrhage/hematoma formation, wound dehiscence, and need for anastomotic revision compared to LMWH/UFH therapy alone. In addition, the overall risk for postoperative complications was not significantly different between these two groups. This preliminary retrospective data suggests that while DVT/PE prevention was improved with the addition of aspirin to heparin-based thromboprophylaxis, the addition of aspirin may even increase some postoperative risks. Further prospective studies are needed to validate these conclusions and inform postoperative management of patients undergoing reconstruction with free flaps. *Source: https://ps-rc.org/meeting/Program/2026/MS22.cgi*

  PublisherDOI

Recent grants

• Fat transplant for glitazone delivery and adiponectin production to inhibit breast cancer

  NIH · $356k · 2015–2018

• Efficacy of Local Tacrolimus Delivery in Allograft Nerve Transplantation

  NIH · $410k · 2015–2018

Frequent coauthors

• Alvin C. Kwok

  University of Utah

  74 shared

• Sujee Jeyapalina

  George E. Wahlen Department of VA Medical Center

  56 shared

• James P. Beck

  University of Utah

  45 shared

• Jill Shea

  University of Utah

  43 shared

• Andrew Simpson

  36 shared

• Shaun D. Mendenhall

  Children's Hospital of Philadelphia

  31 shared

• Lawrence J. Gottlieb

  University of Chicago

  30 shared

• Bruce K. Gale

  26 shared