Is there a preferred protocol for the postoperative use of anticoagulation after free tissue transfer in head and neck ablative procedures, particularly in relation to free flap complications?
Explore this issue:February 2018
There is currently no consensus in the literature on the optimal anticoagulation therapy in patients undergoing free flap reconstruction of the head and neck, and inadequate evidence to develop a standardized protocol.
Background: Free flap outcomes have improved drastically since the introduction of microvascular surgery, but postoperative complications, mostly as the result of venous thrombosis at the pedicle anastomosis, still occur. Despite routine anticoagulant and antiplatelet agent administration, most surgeons rely on anecdotal evidence based on prior use, personal outcomes, and training experiences rather than a set regimen.