Antithrombotic and antinflammatory drugs for protection of microvascular anastomosis.

The results of microsurgical procedures in 43 patients who underwent replantation, as well as free tissue transfer were studied. The following scheme of antithrombotic medication was applied postoperatively: a) 330 mg acetylsalicylic acid and 75 mg dipyridamole; b) 440 mL low molecular weight dextran, divided in 2 doses; c) 60000 IU streptokinase and 15000 IU streptodonase; and d) 100 mg diclofenac. 29 of the patients were completely free of complications. Transient vascular spasm was noted in 10 patients and 2 patients developed necrotic lesions distal to the microvascular anastomosis which resulted in two secondary amputations. These results suggest that although antithrombotic treatment can not be seen as a substitute for fine surgical procedures, it still remains powerful tool in the hands of microsurgeons.