Anticoagulation therapy in microsurgery: A review

The advent of microsurgical tissue transfer including replantation greatly has expanded the scope of reconstructive surgery. There are few recent innovations in anticoagulation therapies for microsurgery, however, an anastomatic thrombosis remains an occasional cause of surgical failure. No concensus exists on the ideal anticoagulation protocol for microsurgey. This article reviews major pharmacologic modalities of anticoagulation, delineates the mechanism of action and study of efficacy of each agent, and compares the risk and benefits of popular anticoagulation therapies. Finally, it examines available human outcomes-based data and attempts to provide a glimpse of the future direction of microsurgical anticoagulation research.