Affiliations: Department of Clinical Haemostaseology and Transfusion Medicine, University of Saarland, Homburg, Germany
Note: [] Corresponding author: Gerhard Pindur, Department of Clinical Haemostaseology and Transfusion Medicine, University of Saarland, 66421 Homburg, Germany. E-mail: [email protected].
Abstract: Despite increasing advances in microvascular free tissue transfer, flap failures, most commonly resulting from thrombosis at the anastomotic vascular site, remain a significant concern. Although several experimental and clinical studies have been carried out, no consensus has been reached so far on the efficacy, dosage and timing of anticoagulant agents available for the prevention and treatment of thrombosis in microvascular surgery. Inhibition of fibrin formation and platelet function or the use of thrombolytic agents is a common approach in the antithrombotic management. However, some agents exhibit serious side effects and all of them carry the risk of bleedings. The current literature on the use of antithrombotic agents, targeting at clinical trials in microvascular surgery, is therefore reviewed, to provide an informative basis for recommendations for an appropriate pharmacological approach.
