title: Testing a New Anticoagulation Method for Free Flap Reconstruction of Head and Neck Cancers.
abstract: OBJECTIVE
  Free flaps are widely used to reconstruct head and neck defects. Despite the improvement in the surgical techniques and the surgeons' experiences, flap failures still occur due to thrombotic occlusion after small vessels anastomosis. To reduce the possibility of flap loss as a result of thrombotic occlusion, various anticoagulants have been used. In this study we decided to evaluate a new protocol for anticoagulation therapy and its effect on flap survival and complications.
  
  
  METHODS
  In this interventional study, 30 patients with head and neck cancer underwent surgical defects were reconstructed by microvascular free flap between 2013 and 2014. In the postoperative period patients have taken aspirin (100 mg/day) for 5 days and enoxaparin (40 mg/day subcutaneously) for 3 days. The flap survival was followed for three weeks.
  
  
  RESULTS
  Given that there was no complete necrosis or loss of flap, the free flap success rate was as much as 100%. The need for re-exploration occurred in 3 patients (10%). Only in one patient the need for re-exploration was due to problem in venous blood flow.
  
  
  CONCLUSIONS
  The aspirin-enoxaparin short-term protocol may be a good choice after free flap transfer in reconstruction of head and neck surgical defects.
authors.affiliation: Department of Otolaryngology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Karimi
authors.affiliation: Department of Otolaryngology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyyed Hadi Samimi
authors.initials: SH
authors.lastname: Ardestani
authors.affiliation: Otolaryngology Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Jafari
authors.affiliation: Department of Otolaryngology, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Ali Bagheri
authors.initials: AB
authors.lastname: Hagh
keywords: Anticoagulants; Free Tissue Flaps; Head and Neck Neoplasms