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Continuous administration of heparin during free flap surgery for head and neck tumors reduces the risk of pulmonary embolism.

Oral and maxillofacial surgery 2026 Vol.30(1)

Goldstein K, Holdorf F, Lier M, Kauffmann P, Brockmeyer P, Khromov T, Wolfer S, Moser N, Hoene G, Schliephake H, Schminke B

PMC 전문 ↗ 원문 ↗ DOI ↗

관련 도메인

피판재건술 Flap Reconstruction 미세수술 Microsurgery

Abstract

[PURPOSE] This study investigated the impact of different anticoagulation protocols on the incidence of pulmonary embolism (PE) in patients with head and neck tumors who underwent microvascular flap reconstruction.

[METHODS] We conducted a retrospective case‒control analysis of 92 patients. Two anticoagulation strategies were evaluated: one group received 10000 IU of unfractionated heparin (UFH) administered over 24 hours (h) starting 6 h postoperatively for one week.The other group received 3 IU of UFH per kilogram of total body weight per h at the onset of surgery until 6 h after surgery. The activated partial thromboplastin time (aPTT) target was subsequently set at 50 to 60 seconds for one week.

[RESULTS] The group that received intraoperative UFH presented a significantly lower incidence of PE (6.5% compared with 17.4% in the group that received 10,000 IU of UFH 6 h postoperatively), independent of the type of flap used for reconstruction. This effect was particularly notable in patients who received a forearm flap for reconstruction. There was no statistically significant difference in the incidence of bleeding requiring intervention between the two groups; however, a trend was noted, as postoperative bleeding occurred more frequently in the group receiving intraoperative heparinization.

[CONCLUSIONS] Our findings suggest that the intraoperative administration of UFH is effective in significantly reducing the risk of PE in patients with head and neck tumors undergoing free flap reconstruction. These results highlight the need for further research to optimize anticoagulation protocols that effectively balance thromboembolic prevention and the risk of bleeding complications.

추출된 의학 개체 (NER)

유형영어 표현한국어 / 풀이UMLS CUI출처등장
시술 flap 피판재건술 dict 3
시술 free flap 피판재건술 dict 2
시술 microvascular 미세수술 dict 1

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이 논문이 참조한 문헌 44

외부 PMID 30건 (DB 미수집)

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