PMID- 9714039
OWN - NLM
STAT- MEDLINE
DCOM- 19981020
LR  - 20160526
IS  - 0743-684X (Print)
IS  - 0743-684X (Linking)
VI  - 14
IP  - 5
DP  - 1998 Jul
TI  - Improved microsurgical anastomotic patency with low molecular weight heparin.
PG  - 331-6
AB  - Blood flow to a free flap may be impaired by thrombotic occlusion at the 
      anastomosis or by microemboli occluding microvessels. The purpose of this study 
      was to test the hypothesis that unfractionated heparin (UFH) or low molecular 
      weight fractions of heparin (LMWH) could improve both the patency of 
      microvascular anastomoses and microcirculatory perfusion. Sixty-six rats 
      underwent orthotopic elevation of 3- x 10-cm epigastric free flaps. Animals 
      received a single injection of either vehicle, UFH or LMWH, prior to 
      microvascular clamp application and pedicle division. Anastomotic patency and 
      tissue survival area were assessed on postoperative day 7. Anastomotic patency 
      was significantly improved in both the UFH and LMWH groups. Total tissue survival 
      area in those flaps with anastomotic patency was significantly improved in the 
      UFH and the LMWH groups. Although both UFH and LMWH significantly elevated 
      activated partial thromboplastin times (APTT) and anti activated clotting factor 
      X (anti-Xa) activity over controls, UFH had its greatest effect on APTT, and LMWH 
      on anti-factor Xa activity. Hematomas developed only in the UFH group. Thus, 
      although both UFH and LMWH improved microcirculatory perfusion, as indicated by 
      increased flap survival, only LMWH improved anastomotic patency while minimizing 
      hemorrhage.
FAU - Ritter, E F
AU  - Ritter EF
AD  - Department of Cell Biology, Duke University Medical Center, Durham, North 
      Carolina 27710, USA.
FAU - Cronan, J C
AU  - Cronan JC
FAU - Rudner, A M
AU  - Rudner AM
FAU - Serafin, D
AU  - Serafin D
FAU - Klitzman, B
AU  - Klitzman B
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Reconstr Microsurg
JT  - Journal of reconstructive microsurgery
JID - 8502670
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9001-29-0 (Factor X)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - *Anastomosis, Surgical
MH  - Animals
MH  - Anticoagulants/administration & dosage/*therapeutic use
MH  - Embolism/prevention & control
MH  - Epigastric Arteries
MH  - Factor X/antagonists & inhibitors
MH  - Follow-Up Studies
MH  - Graft Survival
MH  - Hematoma/etiology/prevention & control
MH  - Heparin/administration & dosage/therapeutic use
MH  - Heparin, Low-Molecular-Weight/administration & dosage/*therapeutic use
MH  - Male
MH  - Microcirculation/drug effects
MH  - *Microsurgery
MH  - Partial Thromboplastin Time
MH  - Postoperative Hemorrhage/prevention & control
MH  - Rats
MH  - Rats, Sprague-Dawley
MH  - Regional Blood Flow/drug effects
MH  - Surgical Flaps/*blood supply
MH  - Thrombosis/prevention & control
MH  - Vascular Patency/*drug effects
EDAT- 1998/08/26 00:00
MHDA- 1998/08/26 00:01
CRDT- 1998/08/26 00:00
PHST- 1998/08/26 00:00 [pubmed]
PHST- 1998/08/26 00:01 [medline]
PHST- 1998/08/26 00:00 [entrez]
AID - 10.1055/s-2007-1000186 [doi]
PST - ppublish
SO  - J Reconstr Microsurg. 1998 Jul;14(5):331-6. doi: 10.1055/s-2007-1000186.