ABSTRACT
In free tissue transfer, the recipient arteries and veins are often damaged by injury,
and their lumens are often narrowed due to thickening of the intima. These factors
are considered paramount in the poor success rate of free tissue transfers. In the
reported study, the authors examined the effects of continuous intraarterial infusion
with heparin and urokinase in experimental epigastric flap transfer. By intraarterial
infusion, the drug concentration at the target site could be significantly increased.
The viability of an epigastric flap transferred to a recipient site with thickened
arterial intima was significantly improved in a rabbit model by a seven-day continuous
local intraarterial infusion of heparin at 10 U/kg/hr and urokinase at 100 IU/kg/hr,
compared with control or intravenous infusion.
Use of an anticoagulant with a fibrinolytic enzyme is considered to be the best choice
for a successful outcome in flap transfer.
