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Postoperative management of antithrombotic medication in microvascular head and neck reconstruction: a comparative analysis of unfractionated and low-molecular-weight heparin.
- Source :
- European Archives of Oto-Rhino-Laryngology; May2021, Vol. 278 Issue 5, p1567-1575, 9p
- Publication Year :
- 2021
-
Abstract
- Purpose: Free flap reconstruction is a valuable technique to preserve function in oncological head and neck surgery. Postoperative graft thrombosis is a dreaded risk. This study aims to compare low-dose unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) in perioperative thrombosis prophylaxis. Methods: This is a retrospective analysis of 266 free flaps performed at our academic center. A comparison was made between 2 patient groups, based on their respective postoperative prophylaxis protocols either with UFH (n = 87) or LMWH (n = 179). Primary endpoints were the frequency of transplant thrombosis and the number of flap failures. Secondary endpoints were the occurrence of peri- and postoperative complications. Results: The flap survival rate was 96.6% and 93.3% for the groups UFH and LMWH, respectively (P = 0.280). The rate of postoperative bleeding requiring revision was 4.6% and 6.7% for each group, respectively (P = 0.498). We found a hematoma formation in 4.6% and 3.9% (P = 0.792). Conclusion: The free-flap survival rate using low-dose UFH seems to be equivalent to LMWH regimens without compromising the postoperative outcome. Consequently, for risk-adapted thrombosis prophylaxis, either LMWH or UFH can be administrated. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09374477
- Volume :
- 278
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- European Archives of Oto-Rhino-Laryngology
- Publication Type :
- Academic Journal
- Accession number :
- 149906099
- Full Text :
- https://doi.org/10.1007/s00405-020-06219-w