Selective heparinization of venous anastomosis in latissimus dorsi free flaps to cover lower-extremity soft-tissue defects.

Two groups of consecutive patients treated with latissimus dorsi free myocutaneous flaps to cover lower-extremity soft-tissue defects were compared for postoperative vascular occlusion. In the first group of 13 patients (group I), there were five (38%) venous occlusions and no arterial occlusions. The second group of 15 patients (group II) was treated with selective heparinization of each venous anastomosis via a 0.35" catheter sutured into the serratus branch of the donor vein. In this group one patient suffered an arterial occlusion, but no patient suffered a venous occlusion. Statistical analysis using the Fisher exact probabilities test showed a significant decrease in vascular occlusion rate in group II, proving that selective heparinization had a beneficial effect on the venous patency rate.