The aim of this study was to compare the influence of two different types of antithrombogenic medication and the technique of anastomosis on flap survival in free tissue transfer. In 81 patients, the postoperative medication was dextran and heparin (Group 1), in 123 patients heparin only (Group 2). After dextran and heparin medication arterial thrombosis occurred in six patients (7.4%), after heparin therapy only in eight patients (6.5%, p=0.79). In 154 patients an arterial end-to-end anastomosis, and in 50 patients an end-to-side anastomosis was performed. Arterial occlusion occurred in 8.9% after end-to-end anastomosis and in no case after end-toside anastomosis (p<0.02). Total flap necrosis occurred in 11 patients (5%), a partial flap necrosis occurred in three patients (2%). The results suggest that it is only the surgical method of anastomosis which has an influence on the survival rate of free flaps, the postoperative medication has no effect.
European Journal of Plastic Surgery – Springer Journals
Published: Aug 3, 1998
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