THE INFLUENCE OF POSTOPERATIVE MEDICAL-TREATMENT AND TYPE OF MICROVASCULAR ANASTOMOSIS ON FREE TISSUE TRANSFER

The aim of this study was to compare the influence of two different ty pes of antithrombogenic medication and the technique of anastomosis on flap survival in free tissue transfer. In 81 patients, the postoperat ive medication was dextran and heparin (Group 1), in 123 patients hepa rin only (Group 2). After dextran and heparin medication arterial thro mbosis occurred in six patients (7.4%), after heparin therapy only in eight patients (6.5%, p=0.79). In 154 patients an arterial end-to-end anastomosis, and in 50 patients an end-to-side anastomosis was perform ed. Arterial occlusion occurred in 8.9% after end-to-end anastomosis a nd in no case after end-to-side anastomosis (p<0.02). Total flap necro sis occurred in 11 patients (5%), a partial flap necrosis occurred in three patients (2%). The results suggest that it is only the surgical method of anastomosis which has an influence on the survival rate of f ree flaps, the postoperative medication has no effect.