Anticoagulants and hematomas in free flap surgery

Plastic and Reconstructive Surgery
S S KrollM A Schusterman

Abstract

A review of systemic anticoagulant use in 517 free flap procedures was performed to determine the associated risk of hematoma formation. Patients were divided retrospectively (not randomly) into five groups: no anticoagulation (227 flaps, 5.3 percent hematomas), low-dose heparin bolus of 2000 to 3000 units and postoperative infusion at a rate of 100 to 400 units/hr for 5 to 7 days (192 flaps, 6.7 percent hematomas), intraoperative bolus of 5000 units of heparin without postoperative anticoagulation (46 flaps, 6.5 percent hematomas), high-dose heparin infusion at a rate of 500 to 1200 units/hr (30 flaps, 20 percent hematomas), and dextran 40 infusion at a rate of 25 ml/hr (22 flaps, 9.1 percent hematomas). Intraoperative blood loss was similar for all groups. The flap loss rate was lower in the bolus (1.0 percent) and low-dose (1.0 percent) heparin groups than in the no-anticoagulation group (4.4 percent), but this difference was not statistically significant. The pedicle thrombosis rate also was lower in the bolus (2.2 percent) and low-dose (2.1 percent) heparin groups than in the no-anticoagulation group (6.2 percent). A cause-and-effect relationship between the use of anticoagulants and flap loss or prevention of thrombosis c...Continue Reading

Citations

Jul 6, 2013·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Francesco M G RivaSeng-Feng Jeng
Apr 10, 2007·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Michael G Moore, Daniel G Deschler
Dec 4, 2002·Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]·Murad Alam, Leonard H Goldberg
Dec 18, 2001·Plastic and Reconstructive Surgery·M H Conrad, W P Adams
Jan 15, 2010·Plastic and Reconstructive Surgery·Franck M P LeclèreSerge R Mordon
Sep 15, 2011·Plastic and Reconstructive Surgery·Christopher J PannucciEdwin G Wilkins
Nov 30, 2012·Plastic and Reconstructive Surgery·Michel Saint-CyrWilliam C Pederson
Feb 7, 2014·Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India·Ashok Raj KoulSushil Nahar
Aug 11, 2007·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Olivier DassonvilleAlexandre Bozec
Feb 19, 2013·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·G H HolomH N Vintertun
Apr 1, 2015·Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery·J E SwartzW W Braunius
Jan 10, 2012·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Graeme E Glass, Jagdeep Nanchahal
Jul 22, 2010·Annales de chirurgie plastique et esthétique·F M P LeclèreS Mordon
Jul 22, 2010·Annales de chirurgie plastique et esthétique·L-A DumontI Garrido-Stowhas
Jul 10, 2010·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·M D Gardiner, J Nanchahal
Mar 20, 2010·Chirurgie de la main·L-A DumontUNKNOWN Fédération européenne des services d'urgence mains (Fesum)
Mar 5, 2016·Journal of Plastic Surgery and Hand Surgery·Toshiaki NumajiriHirofumi Sakaguchi
Mar 7, 2009·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Krystyna MiszkiewiczAndreas Nikolis
Oct 15, 2008·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Victor Médard de ChardonElisa Lebreton
Jul 8, 2008·Oral and Maxillofacial Surgery Clinics of North America·Jason K Potter, Timothy M Osborn
Feb 20, 2007·Clinics in Plastic Surgery·Glyn Jones
Mar 18, 2016·Journal of Plastic Surgery and Hand Surgery·Martin HalleÅsa Edsander-Nord
Dec 17, 2009·Head & Neck·Chin-Ho Wong, Fu-Chan Wei
Aug 22, 2006·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·H RidhaP E Butler
Apr 17, 2015·The Laryngoscope·Faisal I AhmadMark K Wax
Jun 14, 2015·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Alex SenchenkovNho V Tran
Apr 6, 2004·Facial Plastic Surgery Clinics of North America·Tessa Hadlock, Mark Varvares
Oct 9, 2012·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Jessyka G LighthallMark K Wax
Nov 2, 2017·Archives of Craniofacial Surgery·Mun-Young AnNae-Ho Lee
Jul 10, 2013·The Cochrane Database of Systematic Reviews·Yi-Chieh ChenYu-Wen Wen
Nov 1, 2006·The Laryngoscope·Jacob D SteigerJames N Palmer
Feb 6, 2007·The Laryngoscope·Ikuo HyodoShuhei Torii
Jan 19, 2007·Plastic and Reconstructive Surgery·Brandon C D Evans, Gregory R D Evans
May 15, 2007·Plastic and Reconstructive Surgery·J Craig MerrellDennis P Orgill
Mar 5, 2008·Plastic and Reconstructive Surgery·Constance M ChenBabak J Mehrara
Mar 10, 2006·Plastic and Reconstructive Surgery·Alizan A KhalilJohn C Hall
Jun 13, 2018·Craniomaxillofacial Trauma & Reconstruction·Manoj AbrahamYadranko Ducic
Sep 16, 2016·Plastic and Reconstructive Surgery·Eugenia H ChoScott T Hollenbeck

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.