Is the Use of Intraoperative Heparin Safe?

Abstract

Intraoperative systemic heparin use has no statistically significant effect on the incidence of microvascular thrombosis. In addition, administration of a single dose of intraoperative heparin does not increase the rate of hematoma formation or prevent microvascular thrombosis. Thus, critical factors for flap survival are likely independent of the use of intraoperative anticoagulation.

Clinical Use of Anticoagulants Following Replantation Surgery

“…Their results showed no statistically significant difference in the incidence of microvascular thrombosis, total or partial flap loss, hematoma, seroma, pulmonary embolism, or death. 7 Ashjian et al recently investigated aspirin versus low-molecular-weight heparin in postoperative therapy. They reported no difference in microvascular thrombosis or other complications.…”

Prevention of thrombosis after microvascular tissue transfer in the head and neck. A review of the literature and the state of affairs in Dutch Head and Neck Cancer Centers

“…Thrombosis is a frequent complication in free-flap surgery. Thrombosis occurs in 8-14% of cases and often leads to flap failure (1-9%) 10,15,31 . Flap failure due to thrombosis in the head and neck region is, in most cases, caused by venous and not arterial thrombosis 18,28 .…”

Thromboelastometry: A contribution to perioperative free-flap management

“…A study performed by Chen et al (2008) found intraoperative systemic heparin to have no statistically significant effect on the incidence of microvascular thrombosis. Additionally, Chen et al (2008) stated the administration of a single dose of intraoperative heparin did not increase the rate of hematoma formation or prevent microvascular thrombosis. Nevertheless, the change in coagulability was not noted.…”

“…Consequently, the individual response to a heparin bolus forbade an overall statement. It was concluded that critical factors for flap survival are likely to be independent concerning the use of intraoperative anticoagulation (Chen et al, 2008).…”