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J Reconstr Microsurg 2008; 24(5): 305-314
DOI: 10.1055/s-2008-1080530
© Thieme Medical Publishers

Prevention and Treatment of Thrombosis in Microvascular Surgery

Matthew M. Hanasono1 , Charles E. Butler1
  • 1Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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Publication History

Publication Date:
09 July 2008 (online)

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ABSTRACT

Microvascular free tissue transfer is associated with a 1 to 5% failure rate, most commonly as a result of thrombosis in the region of the vascular anastomosis or the distal flap microcirculation. Although many laboratory and clinical studies have been performed, there is no consensus on the efficacy and optimal dosage of various pharmacological agents available for the prevention and treatment of thrombosis in microvascular surgery. Some agents have potentially serious side effects; and all agents carry the risks of undesirable bleeding and hematoma formation. We review the current experimental and clinical evidence regarding the agents commonly used to prevent and treat thrombosis in microvascular surgery and make practical recommendations for the management of vascular compromise in free flaps.

KEYWORDS

Anticoagulation - free flap - microvascular - thrombosis - thrombolysis

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Matthew M HanasonoM.D. 

Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center

1515 Holcombe Blvd., Unit 443, Houston, TX 77030

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