Postoperative management of antithrombotic medication in microvascular head and neck reconstruction: a comparative analysis of unfractionated and low-molecular-weight heparin

Sievert M, Goncalves M, Tamse R, Müller SK, Koch M, Gostian AO, Iro H, Scherl C (2020)

Publication Type: Journal article

Publication year: 2020

Journal

European Archives of Oto-Rhino-Laryngology Springer

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.

Authors with CRIS profile

Matti Sievert Department of Otorhinolaryngology – Head and Neck Surgery Miguel Goncalves Medizinische Fakultät Sarina Müller-Hübner Department of Otorhinolaryngology – Head and Neck Surgery Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde

How to cite

APA:

Sievert, M., Goncalves, M., Tamse, R., Müller, S.K., Koch, M., Gostian, A.O.,... Scherl, C. (2020). Postoperative management of antithrombotic medication in microvascular head and neck reconstruction: a comparative analysis of unfractionated and low-molecular-weight heparin. European Archives of Oto-Rhino-Laryngology. https://doi.org/10.1007/s00405-020-06219-w

MLA:

Sievert, Matti, et al. "Postoperative management of antithrombotic medication in microvascular head and neck reconstruction: a comparative analysis of unfractionated and low-molecular-weight heparin." European Archives of Oto-Rhino-Laryngology (2020).

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