This retrospective cohort study compared three anticoagulation protocols (intravenous unfractionated heparin [IV-UFH], subcutaneous UFH [SC-UFH], and SC-UFH plus aspirin) in patients undergoing head and neck flap reconstruction. The novelty lies in the direct comparison of these regimens within a defined microsurgical population, using multivariate analysis to control for confounding factors.

In the unadjusted analysis, IV-UFH was associated with a significantly higher risk of flap compromise compared to SC-UFH, while adding aspirin did not provide a significant protective effect. After adjustment, anticoagulation type was not significantly associated with flap compromise overall; however, subgroup analysis indicated that IV-UFH remained associated with higher odds of flap compromise.

Overall, SC-UFH may represent a more practical approach than intravenous administration, although no definitive superiority among protocols was established.

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نویسنده:

Samah Mouzannar 1, Amirmohsen Jalaeefar 2, Mohammad Shirkhoda 3, Fereidoon Memari 3, Ali Arab Kheradmand 4, Ata Garajei 5, Arshia Zardoui 6, Seyed Masoumeh Valizadeh-Otaghsara 7, Amirmohammad Bakhtiari 7, Amirsina Sharifi 8