Relationship between coagulation factor XIII and wound complications in head and neck surgery

Abstract

Coagulation factor XIII is activated by thrombin at the final stage of the coagulation reaction and has the effect of cross-linking fibrins to each other. The fibrins form a thrombus, which provides mechanical resistance. When coagulation factor XIII is deficient, the fibrin thrombus dissolves before tissue repair progresses, causing bleeding at the same site half a day after hemostasis. A large amount of coagulation factor XIII is said to be consumed by highly invasive surgery. In this study, we retrospectively analyzed the characteristics of 16 patients whose factor XIII levels were measured after head and neck surgery between 2012 and 2020. Ten of the 16 patients (62.5%) had decreased factor XIII levels. Factor XIII tended to decrease in patients with frequent bleeding, and wound complications occurred more frequently in the XIII-deficient group than in the normal-range group. Knowledge of coagulation factor XIII is essential for otolaryngologists/head and neck surgeons to prevent and control wound complications.