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Could Lipo-Prostaglandin E1 Be the Key to Improving Success Rates in Free-Flap Microsurgery? A Systematic Review.
1Plastic Surgery, Department of Surgery, College of Medicine, Prince Sattam bin Abdulaziz University, Al-Kharj 16273, Saudi Arabia.
Journal of Clinical Medicine
|January 10, 2026
Summary
Prostaglandin E1 (PGE1) and lipo-PGE1 show promise in microsurgery for improving blood flow and preventing clots in free flaps. Further research is needed to confirm their benefits in complex surgical procedures.
Area of Science:
- Surgical Innovation
- Vascular Biology
- Pharmacology
Background:
- Microsurgery and free tissue transfer are vital for restoring form and function.
- Maintaining blood flow and preventing thrombosis are critical challenges in microsurgery.
- Prostaglandin E1 (PGE1) and its liposomal form (lipo-PGE1) possess vasodilatory and anticoagulant properties.
Purpose of the Study:
- To systematically review the use, effects, and efficacy of lipo-PGE1 and PGE1 in microsurgery.
- To evaluate their role in improving blood flow and preventing thrombosis in free flaps.
Main Methods:
- Systematic review of studies up to 2024.
- Searched PubMed, MEDLINE, and Embase using keywords: "flap," "prostaglandin E1," "microsurgery."
- Qualitative analysis of 14 selected articles.
Main Results:
- PGE1/lipo-PGE1 was used in various microsurgical reconstructions, predominantly in head and neck.
- Commonly used flaps included anterolateral thigh flaps.
- Reported uses included antithrombotic, anticoagulant, vasodilator effects, and blood flow assessment.
- One study showed significantly lower perfusion complications with prostaglandin use.
Conclusions:
- Lipo-PGE1/PGE1 demonstrates potential for enhancing blood flow in free flaps and preventing microanastomosis thrombosis.
- Further multicenter, randomized controlled studies are essential to validate these benefits.
