PMID- 37845093
OWN - NLM
STAT- MEDLINE
DCOM- 20231106
LR  - 20231106
IS  - 1878-4119 (Electronic)
IS  - 1010-5182 (Linking)
VI  - 51
IP  - 10
DP  - 2023 Oct
TI  - Heparin regimes in head and neck cancer flap surgery: A retrospective cohort 
      study of free flap complications graded by Clavien-Dindo.
PG  - 629-634
LID - S1010-5182(23)00188-9 [pii]
LID - 10.1016/j.jcms.2023.09.015 [doi]
AB  - The purpose of the current study was to compare two different antithrombotic 
      protocols for free flap reconstruction in head and neck squamous cell carcinoma 
      (HNSCC) patients. Postoperative complications were graded using the Clavien-Dindo 
      (CD) classification and compared between the two groups: the low-molecular-weight 
      heparin (LMWH) group (n = 57) and the unfractionated heparin (UFH) group 
      (n = 59). Patients with HNSCC from January 2010 to January 2022 were included. A 
      total of 116 patients with a mean age of 60.46 years (range 43-83 years) were 
      included in this study. In all, 81 were male (69.8%), and 35 were female (30.2%). 
      Most patients (48.3%) had only grade 1 or 2 complications. CD grades (1-5) were 
      similar between the two groups. Flap loss occurred in 2 patients (1.7%) in the 
      LMWH group (p = 239). Prognostic factors of flap loss were high BMI, 
      hypertension, high T stage, and high N stage. No differences were found between 
      the groups in regard to age, sex, operating times, flap source, recipient vessels 
      and overall complications. The results of this study demonstrate that UFH was as 
      safe and effective as LMWH regarding postoperative complications. Free flap 
      surgery is safe and effective for head and neck reconstruction.
CI  - Copyright (c) 2023. Published by Elsevier Ltd.
FAU - Tomic, Josip
AU  - Tomic J
AD  - Department of Oral and Maxillofacial Surgery, Medical University of Graz, Graz, 
      Austria. Electronic address: josip.tomic@medunigraz.at.
FAU - Starke, Vasco
AU  - Starke V
AD  - Department of Oral and Maxillofacial Surgery, Medical University of Graz, Graz, 
      Austria.
FAU - Wallner, Jurgen
AU  - Wallner J
AD  - Department of Oral and Maxillofacial Surgery, Medical University of Graz, Graz, 
      Austria.
FAU - Zemann, Wolfgang
AU  - Zemann W
AD  - Department of Oral and Maxillofacial Surgery, Medical University of Graz, Graz, 
      Austria.
FAU - Gary, Thomas
AU  - Gary T
AD  - Division of Angiology, Department of Internal Medicine, Medical University of 
      Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
FAU - Pau, Mauro
AU  - Pau M
AD  - Department of Oral and Maxillofacial Surgery, Medical University of Graz, Graz, 
      Austria.
LA  - eng
PT  - Journal Article
DEP - 20231012
PL  - Scotland
TA  - J Craniomaxillofac Surg
JT  - Journal of cranio-maxillo-facial surgery : official publication of the European 
      Association for Cranio-Maxillo-Facial Surgery
JID - 8704309
RN  - 9005-49-6 (Heparin)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Humans
MH  - Male
MH  - Female
MH  - Adult
MH  - Middle Aged
MH  - Aged
MH  - Aged, 80 and over
MH  - Heparin/adverse effects
MH  - Heparin, Low-Molecular-Weight
MH  - *Free Tissue Flaps
MH  - Retrospective Studies
MH  - Squamous Cell Carcinoma of Head and Neck
MH  - Postoperative Complications/surgery
MH  - *Head and Neck Neoplasms/surgery
OTO - NOTNLM
OT  - Anticoagulation
OT  - Free flap loss
OT  - Head and neck cancer
OT  - Heparin
OT  - Microvascular reconstruction
EDAT- 2023/10/17 00:42
MHDA- 2023/11/06 06:42
CRDT- 2023/10/16 21:59
PHST- 2023/07/11 00:00 [received]
PHST- 2023/08/17 00:00 [revised]
PHST- 2023/09/30 00:00 [accepted]
PHST- 2023/11/06 06:42 [medline]
PHST- 2023/10/17 00:42 [pubmed]
PHST- 2023/10/16 21:59 [entrez]
AID - S1010-5182(23)00188-9 [pii]
AID - 10.1016/j.jcms.2023.09.015 [doi]
PST - ppublish
SO  - J Craniomaxillofac Surg. 2023 Oct;51(10):629-634. doi: 
      10.1016/j.jcms.2023.09.015. Epub 2023 Oct 12.