Does Intraoperative Heparin Administration Reduce Postoperative Complications in Deep Inferior Epigastric Perforator...

Area of Science:

• Microsurgery
• Plastic Surgery
• Thrombosis Research

Background:

• Microsurgical thrombosis is a significant complication in free flap surgery.
• Limited evidence exists on intraoperative thromboprophylaxis for deep inferior epigastric perforator (DIEP) flap breast reconstruction.
• This study retrospectively analyzed DIEP flap breast reconstructions over a 6-year period.

Purpose of the Study:

• To evaluate the efficacy of intraoperative unfractionated heparin (UFH) in preventing microsurgical thrombosis during DIEP flap breast reconstruction.
• To assess the safety profile of perioperative UFH administration in this patient population.

Main Methods:

• Retrospective analysis of 114 patients undergoing DIEP flap breast reconstruction (January 2018 - June 2024).
• Patients were divided into a control group and a treatment group receiving intraoperative unfractionated heparin (UFH) bolus.
• Outcomes including intraoperative, acute, and delayed complications were analyzed.

Main Results:

• No significant difference in intraoperative, acute, or delayed complications between the UFH and control groups.
• The risk of thrombosis and hematoma was comparable between groups.
• The control group experienced significantly longer ischemia times and total operative durations.

Conclusions:

• Intraoperative anticoagulant prophylaxis with UFH did not reduce acute thrombotic complications in DIEP flap breast reconstruction.
• UFH administration was not associated with an increased risk of hematoma or bleeding.
• Findings provide insights into the clinical relevance and safety of perioperative UFH.