{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T20:55:51Z","timestamp":1793912151895,"version":"4.8.0"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Abdominal\u2010based free flaps are the mainstay in autologous breast reconstruction. Their safety and consistency in outcomes are well\u2010documented. When flap compromise occurs, operative salvage is the gold standard. However, when\u2014and if\u2014to place these patients on heparin infusions is unclear. The goal of this study was to investigate abdominal\u2010based free flap compromise and compare outcomes with and without heparin infusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This was a single\u2010institution, multiple\u2010surgeon, retrospective chart review of patients undergoing autologous, abdominal\u2010based free flap breast reconstruction who experienced anastomotic compromise within a 6\u2010year period. Treatment and outcomes data collected include flap salvage, hematoma, seroma, surgical site infection (SSI), transfusion requirement, and length of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty\u2010one flaps had evidence of compromise. A total of 31 (60.8%) patients were placed on heparin infusions after experiencing anastomotic compromise, compared to 20 who did not receive heparin infusion. Thirty\u2010five patients (68.6%) underwent deep inferior epigastric perforator flaps. Twenty\u2010six patients (51%) experienced venous congestion, 22 patients (43.1%) experienced arterial compromise, and three (5.9%) experienced both. Twenty\u2010eight patients (54.9%) received tissue plasminogen activator; in the heparin infusion group, 21 patients (67.7%) received tissue plasminogen activator. The total salvage rate of compromised flaps was 94.1% (48\/51). There was no significant difference between heparin infusion and standard cares in length of hospital stay, length of drains in\u2010place, successful salvage (93.5% vs. 95%), hematoma (19.4% vs. 15%), fat necrosis, SSI, hospital readmission (19.4% vs. 15%), and return rates to the operating room (48.4% vs. 50%). However, there was a significantly higher transfusion rate in patients receiving heparin infusion (38.7% vs. 10%). Of the 25 flaps with evidence of thrombosis, 72% were placed on heparin infusions while 28% were not; there was no significant difference in salvage rate in this sub\u2010group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This review of autologous breast reconstruction free flap compromise provides evidence of similar safety profiles, with similar salvage rates, when comparing salvage with and without heparin infusion; there is a higher transfusion requirement when treating with heparin infusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/micr.70065","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T08:15:03Z","timestamp":1746692103000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy and Morbidity of Heparin Infusion in Salvaging Autologous Breast Reconstruction Free Flaps"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3151-8729","authenticated-orcid":false,"given":"Scott K.","family":"Odorico","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Sabry","family":"Mazroua","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leda","family":"Wang","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Awadallah","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Day","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christin","family":"Harless","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorys","family":"Martinez\u2010Jorge","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna","family":"Vijayasekaran","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"issue":"1","key":"e_1_2_9_2_1","article-title":"Early Venous Congestion After Diep Flap Breast Reconstruction: Case Report of a Successful Management","volume":"93","author":"Baccarani A.","year":"2022","journal-title":"Acta 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