Clinical Use of Anticoagulants Following Replantation Surgery

Levin, L. Scott; Cooper, Ellis O.

doi:10.1016/j.jhsa.2008.08.009

Cited by 35 publications

(17 citation statements)

References 11 publications

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“…Systemic anticoagulation is generally not indicated because of potential bleeding from local trauma and other injuries. 3,9 The orthopedic injuries generally guide rehabilitation protocols, but with appropriate care in anastomosis and grafting, the patient can be allowed to start motion fairly early. Long-term follow-up in patients with injury to one of the major arteries of the upper extremity have shown significant sequela, including reduced bone mineral density of the distal radius and decrease in grip strength.…”

Section: Open Traumamentioning

confidence: 99%

Acute Ischemia of the Upper Extremity

Pederson

2016

Orthopedic Clinics of North America

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Section: Open Traumamentioning

confidence: 99%

Acute Ischemia of the Upper Extremity

Pederson

2016

Orthopedic Clinics of North America

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“…Replantation is considered an important source of challenge in reconstructive microsurgery with a considerable risk of thrombosis (7-32 %) and eventual failure [1]. The risk of thrombosis is greatest within the first 48 h after microsurgical revascularization [2]. Platelet aggregation is the underlying cause of arterial thrombosis whereas venous thrombosis is primarily the result of fibrin clotting [3].…”

Section: Introductionmentioning

confidence: 99%

Experimental Thromboprophylaxis with Low Molecular Weight Heparin After Microsurgical Revascularization

Yousef

Dionigi

2016

J Hand Microsurg

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There is great variability among microsurgeons as regards the use of prophylactic anticoagulant after revascularization and this is probably due to lack of comparative data. Also, there has been much debate regarding the benefit of anti-thrombotic therapies versus the risk of complications such as systemic bleeding and hematoma formation. To evaluate the effectiveness of postoperative low molecular weight heparin (LMWH) as a prophylactic anticoagulant therapy after microsurgical repair of the femoral artery and vein in rats. Randomized, blinded study. The femoral artery and vein of 40 Sprague Dawley rats were sectioned and repaired with microsurgical sutures under general anesthesia. They were randomly divided into 2 groups: Group (A) in which the 20 rats were injected with Enoxaparin subcutaneously at a dose 1.5 mg/kg once daily for 3 successive days; Group (B), the control group, in which 20 rats were injected with isotonic sodium chloride 0.9 % subcutaneously in a blinded fashion. After 7 days, the femoral vessels were re-explored and patency of the femoral vessels was assessed with empty-and-refill test. There were a total of 12 vascular thrombosis among 74 microsurgical repair in both groups with percentage of 16.22 % including, 5 arterial anastomosis and 7 venous anastomosis. The incidence of thrombosis in the treatment group (A) was 18.4 % while the incidence of thrombosis in the control group (B) was 13.8 %. This difference was not statistically significant using Fisher exact test. Postoperative administration of LMWH did not provide the desired protection against thrombosis after microsurgical vascular repair.

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“…7 Cited positive predictors of complications after cranioplasty include a history of irradiation, preoperative infection, 9 pneumocephalus, 16 nicotine abuse, age older than 60 years, lower Glasgow Outcome Scale, 19 and bifrontal cranioplasty. 20,21 However, despite a large body of research on perioperative anticoagulation, and the growing number of patients diagnosed with thromboembolic disease each year, [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] no study to date has investigated the impact of perioperative anticoagulant therapy on complications following cranioplasty reconstruction. In this study, we explore the association of perioperative anticoagulant use and/or a hypercoagulable state with minor/major complications in patients undergoing reconstructive cranioplasty for large skull defects.…”

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confidence: 99%