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Microvascular free flap reconstruction is frequently used to treat head and neck defects [1, 2]. However, distal ischemia often occurs, and necrosis has become an important area of focus [3]. Several classes of drugs are prescribed for patients following flap reconstruction to improve flap survival. Among these, antiplatelet drugs, which inhibit platelet agglutination and thrombus formation, have been used as a first treatment for thrombotic complications [4]. Other options include prostaglandin and low-molecular-weight heparin [5, 6]. However, another study revealed that anticoagulation therapy did not significantly improve flap survival [7, 8]. Alprostadil (Prostaglandin E1) is a vasodilator and smooth muscle relaxant that is commonly used for flap survival in patients who undergo free flap reconstruction. A retrospective analysis revealed that thromboprophylaxis regime, such as prostaglandin, has a higher success rate with respect to preventing flap failure [9]. Prostaglandin E1 (PGE1) may cause side effects such as cutaneous vasodilation, edema, and phlebitis. Therefore, PGE1 is not the best treatment option for all individuals [10]. Nevertheless, some patients are still treated with PGE1 following flap reconstruction. Phlebitis is the most common adverse event in patients who receive an intravenous (IV) solution of alprostadil [11]. A Abstract Background: Prostaglandin E1 (PGE1) is a vasodilator and smooth-muscle relaxant commonly used in patients with free flap reconstruction to increase the survival rate of the flap. However, phlebitis is the most common adverse event in patients who receive an intravenous solution of PGE1, and it will lead to more medical treatment.

Phlebitis Induced by Intravenous Prostaglandin E1 in Patients with Malignancy Following Flap Reconstruction: A Case Series Study