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Continuous local intraarterial infusion of anticoagulants for microvascular free tissue transfer in primary reconstruction of the lower limb following resection of sarcoma
Author(s) -
Saito Akira,
Sawaizumi Masayuki,
Imai Tomohiro,
Matsumoto Seiichi
Publication year - 2010
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.20742
Subject(s) - medicine , resection , sarcoma , surgery , free flap , microsurgery , lower limb , pathology
Abstract In free tissue transfers, preventing microvascular thrombosis is the first priority to achieve a successful result. Numerous protocols exist for preventing thrombosis postoperatively. We performed continuous local intraarterial infusion of anticoagulants in 11 patients undergoing wide resection of malignant soft tissue tumors, followed by primary microvascular reconstruction in the lower limb. A catheter designed for epidural anesthesia was inserted into the femoral artery and connected to a syringe pump. A daily dose of 100 ml comprising 2,000 U of heparin and 40 μg of prostaglandin E 1 was administered by means of continuous infusion for seven consecutive days as a standard regime. There were no cases of thrombosis during the continuous local intraarterial infusion of anticoagulants. There were no serious systemic complications. Although we have described limited cases and supporting data are lacking, we feel that this procedure might be useful for microsurgical reconstruction of the lower limb. © 2010 Wiley‐Liss, Inc. Microsurgery 30:376–379, 2010.