Askari Morad, Fisher Christine, Weniger Frederick G, Bidic Sean, Lee W P Andrew
Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, CA, USA.
J Hand Surg Am. 2006 May-Jun;31(5):836-46. doi: 10.1016/j.jhsa.2006.02.023.
The advent of microsurgical tissue transfer including replantation greatly has expanded the scope of reconstructive surgery. There are few recent innovations in anticoagulation therapies for microsurgery, however, and anastomotic thrombosis remains an occasional cause of surgical failure. No consensus exists on the ideal anticoagulation protocol for microsurgery. This article reviews major pharmacologic modalities of anticoagulation, delineates the mechanism of action and study of efficacy of each agent, and compares the risks and benefits of popular anticoagulation therapies. Finally, it examines available human outcomes-based data and attempts to provide a glimpse of the future direction of microsurgical anticoagulation research.
