The outcome of microvascular free flap surgery with or without the use of postoperative heparin.

OBJECTIVE To determine the outcome of microvascular free tissue transfer with or without use of postoperative heparin in terms of flap viability and postoperative complications. STUDY DESIGN Quasi-experimental study. PLACE AND DURATION OF STUDY Department of Plastic Surgery, King Edward Medical University, Lahore, from July 2010 to July 2012. METHODOLOGY Thirty eight patients requiring elective or emergency microvascular free tissue transfer were selected. Those with poly-trauma, previous failed free flap and re-anastomosis of vessels were excluded from the study. All anastomoses were performed by trained microvascular surgeons. Per operatively, Aucland test was performed to ensure anastomotic patency. Thereafter, patients were divided into two groups: in group A, heparin was not given postoperatively and in group B, heparin was given postoperatively. The flaps were monitored for signs of vascular compromise, viability or non-viability and complications of the procedure. Chi-square test was used to compare the distribution of qualitative variable in two groups. P-value less than 0.05 was considered significant. RESULTS In group A, the number of viable flaps was 13 (81%) and non-viable flaps were 3 (19%). In group B the number of viable flaps was 11 (73%) and non-viable flaps were 04 (23%) [p = 0.68]. There was no significant difference regarding postoperative complications between the two groups (p > 0.05). CONCLUSION Postoperative heparin does not appear to have an influence on the viability or complications of free flaps.