The Clinical Study Of Using Low-Molecular-Weight Heparin In The Small Saphenous Vein Of Sural Neurovascular Flap

Objectives To evaluate the effect of low-molecular-weight heparin in the end of the small saphenous vein of the ditally-based fascial flap to reduce venous congestion and increase flap survival quality.Methods From March 2011 to December 2015,54 patients were treated with sural neurovascular flap for coverage of wounds of the down third of the leg,foot and ankle.The flap area was about 14.0cm×11.0cm-10.0cm×8.0cm.The patients were divided into control groups(n=28) and experimental group(n=26). Conventional treatment was given to the patients in control group,while in experimental group there was a venous indwelling needle(Vasofix-R)in the end of the small saphenous vein,0.1ml(1000AXa IU)low-molecular-weight heparin was used each 4h by the needle in the vein for 6days.Blood circulation of the flap was observed postoperatively.Patients received postoperative healing score,the evaluttion criteria includes the days of blood oozing, the swelling degree of flap after the operantion from 1d,3d,5d,the occurrence of skin flap necrosis and the survival rate of flap.The laboratory examination of the blood coagulation four(PT,APTT,TT,FIB) and Hb before and after the operantion from 1d,3d,7d.Then compared the postoperative healing situation of the patients from the two groups. All the data of the two group were analysised by SPSS 17.0.Results The time of blood oozing was longer in experimental group(3.69±0.738d)than that in control group(2.07±0.604),there was difference in two group(P<0.05).Observing and comparing the swelling degree of flaps in 1d,3d,5d after the operation,there was significant difference between the two groups on the 3rd?5thday(P<0.05).There was only one case with partial necrosis in experimental group,however six cases in control group.Compare the control groups and experimental group survival rate of skin flap,there was difference in two group(P<0.05).The laboratory examination of the blood coagulation(PT,APTT,TT,FIB)and Hb before and after the operantion from 1d,3d,7d was no difference in two groups(P>0.05).Conclusions The application of low molecular weight heparin can alleviate the swelling of the flap and increase the quality of flap survival through increasing bleeding time of flaps to release venous congestion for the flaps.It is reliable and there is little effect on the body and no side effect.