PMID: 701764Sep 1, 1978Paper

Pharmacological alterations in the clotting mechanism: use in microvascular surgery

The Journal of Hand Surgery
L D Ketchum

Abstract

At the present time there is confusion as to what pharmacological adjuncts are helpful toward increasing patency rates of microvascular repairs. To select a drug rationally, an understanding of the clotting mechanism in small vessels is essential so that agents may be selected that alone or in combination will react with the elements of the blood and will allow for continued perfusion without risk of hemorrhage or toxicity. Drugs which are Federal Drug Aministration approved and currently available are drugs having nonspecific effects involving more than one aspect of the clotting mechanism; they often in undesirable as well as desirable effects. Further development will result in the use of more selective and sophisticated agents. Presently it would appear desirable to employ agents to (1) increase blood flow and decrease blood viscosity, such as dextran 70; (2) decrease platelet functions, such as aspirin-type drugs; (3) mitigate against the actions of thrombin on platelets and fibrinogen using low-dose heparin; (4) reduce anxiety and vasospasm using chlorpromazine or Thorazine.

References

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Citations

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
Sep 1, 1996·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·M B HirigoyenD Buchbinder
May 23, 2006·The Journal of Hand Surgery·Morad AskariW P Andrew Lee
Nov 2, 2017·Archives of Craniofacial Surgery·Mun-Young AnNae-Ho Lee
Apr 1, 1996·Plastic and Reconstructive Surgery·R J RestifoP C Johnson
Jul 10, 2013·The Cochrane Database of Systematic Reviews·Yi-Chieh ChenYu-Wen Wen
Oct 30, 2013·Plastic and Reconstructive Surgery·Leila JazayeriJames Chang
Apr 18, 2020·The Cochrane Database of Systematic Reviews·Pei-Tzu LinChing-Chi Chi
Jan 21, 2003·Archives of Facial Plastic Surgery·Babak AzizzadehKeith E Blackwell
Mar 1, 1992·The Journal of Hand Surgery·H J FurnasH J Buncke

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