title: Local Intraluminal Irrigation With Argatroban During Free Flap Repair in a Patient With Heparin-Induced Thrombocytopenia.
abstract: OBJECTIVE
  This study describes a case of a successful free flap repair using argatroban for local intraluminal irrigation as a substitute to heparin in a patient with heparin-induced thrombocytopenia.
  
  
  METHODS
  Case report and review of literature.
  
  
  RESULTS
  The patient had an uneventful postoperative course, and the free flap survived without complications.
  
  
  CONCLUSIONS
  The use of argatroban during microvascular surgery is likely to be safe and simple and may be effective in preventing micro-thrombotic complications during microvascular surgery, and it should be considered as an alternative to heparinized saline for local intraluminal irrigation.
authors.affiliation: 1 Loma Linda University School of Medicine, Loma Linda, California, USA.
authors.forename: David
authors.initials: D
authors.lastname: Macias
authors.affiliation: 2 Loma Linda University Medical Center, Department of Otolaryngology, Head & Neck Surgery & Facial Plastic Surgery, Loma Linda, California, USA.
authors.forename: Daniel I
authors.initials: DI
authors.lastname: Kwon
authors.affiliation: 2 Loma Linda University Medical Center, Department of Otolaryngology, Head & Neck Surgery & Facial Plastic Surgery, Loma Linda, California, USA.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Walker
authors.affiliation: 2 Loma Linda University Medical Center, Department of Otolaryngology, Head & Neck Surgery & Facial Plastic Surgery, Loma Linda, California, USA.
authors.forename: Nathaniel R
authors.initials: NR
authors.lastname: Peterson
mesh_terms: D001120:Arginine / Q000031:analogs & derivatives; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D005260:Female; D005542:Forearm / Q000601:surgery; D058752:Free Tissue Flaps / Q000098:blood supply; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery; D037981:Neck Dissection / Q000379:methods*; D010875:Pipecolic Acids / Q000008:administration & dosage*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D017534:Radial Artery / Q000601:surgery; D013449:Sulfonamides; D016896:Treatment Outcome
chemical_list: D010875:Pipecolic Acids; D010975:Platelet Aggregation Inhibitors; D013449:Sulfonamides; D001120:Arginine; C031942:argatroban
keywords: argatroban; free flap reconstruction; head and neck cancer; head and neck reconstruction; head and neck surgery; heparin-induced thrombocytopenia; microsurgery; radial forearm free flap