Efficacy and Morbidity of Heparin Infusion in Salvaging Autologous Breast Reconstruction Free Flaps.
Research article published in Microsurgery (2025)
Abstract
BACKGROUND: Abdominal-based free flaps are the mainstay in autologous breast reconstruction. Their safety and consistency in outcomes are well-documented. When flap compromise occurs, operative salvage is the gold standard. However, when-and if-to place these patients on heparin infusions is unclear. The goal of this study was to investigate abdominal-based free flap compromise and compare outcomes with and without heparin infusion. MATERIALS AND METHODS: This was a single-institution, multiple-surgeon, retrospective chart review of patients undergoing autologous, abdominal-based free flap breast reconstruction who experienced anastomotic compromise within a 6-year period. Treatment and outcomes data collected include flap salvage, hematoma, seroma, surgical site infection (SSI), transfusion requirement, and length of hospital stay. RESULTS: Fifty-one flaps had evidence of compromise. A total of 31 (60.8%) patients were placed on heparin infusions after experiencing anastomotic compromise, compared to 20 who did not receive heparin infusion. Thirty-five patients (68.6%) underwent deep inferior epigastric perforator flaps. Twenty-six patients (51%) experienced venous congestion, 22 patients (43.1%) experienced arterial compromise, and three (5.9%) experienced both. Twenty-eight patients (54.9%) received tissue plasminogen activator; in the heparin infusion group, 21 patients (67.7%) received tissue plasminogen activator. The total salvage rate of compromised flaps was 94.1% (48/51). There was no significant difference between heparin infusion and standard cares in length of hospital stay, length of drains in-place, successful salvage (93.5% vs. 95%), hematoma (19.4% vs. 15%), fat necrosis, SSI, hospital readmission (19.4% vs. 15%), and return rates to the operating room (48.4% vs. 50%). However, there was a significantly higher transfusion rate in patients receiving heparin infusion (38.7% vs. 10%). Of the 25 flaps with evidence of thrombosis, 72% were placed on heparin infusions while 28% were not; there was no significant difference in salvage rate in this sub-group. CONCLUSIONS: This review of autologous breast reconstruction free flap compromise provides evidence of similar safety profiles, with similar salvage rates, when comparing salvage with and without heparin infusion; there is a higher transfusion requirement when treating with heparin infusion.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Резюме
Abdominal-based free flaps are the mainstay in autologous breast reconstruction. Their safety and consistency in outcomes are well-documented.
Почему это важно для гирудотерапии
В данном ретроспективном анализе историй болезни одного учреждения проводилось сравнение результатов в 51 случае нарушенного кровоснабжения аутологичных свободных абдоминальных лоскутов при реконструкции молочной железы с инфузией гепарина и без неё; значимой разницы в показателях спасения лоскута выявлено не было (93,5% против 95%), однако частота гемотрансфузий была значительно выше при применении гепарина (38,7% против 10%, p не указан). Исследование имеет косвенную контекстную релевантность для сферы ASH, поскольку реконструктивная хирургия свободными лоскутами относится к областям, где пиявкотерапия иногда применяется для спасения лоскута при венозном застое, хотя в данной аннотации отсутствует упоминание пиявок или гирудина. ОГОВОРКА: Данное исследование посвящено исключительно системной инфузии гепарина и не предполагает использования пиявкотерапии, бивалирудина или какого-либо соединения пиявочного происхождения; любая связь со сферой ASH ограничивается общим клиническим контекстом спасения микрососудистых лоскутов.
Цитирование
Efficacy and Morbidity of Heparin Infusion in Salvaging Autologous Breast Reconstruction Free Flaps.
Odorico et al. · Microsurgery, 2025
Связанный клинический контекст
Узнайте, как это исследование связано с клинической практикой
Добавлено в библиотеку ASH: May 28, 2026 · Последнее обновление сайта: 18 июня 2026 г.