Does Intraoperative Heparin Administration Reduce Postoperative Complications in Deep Inferior Epigastric Perforator Flap Breast Reconstruction?

Description

Edward T.C. Dong and colleagues asked whether a shot of heparin during DIEP flap breast reconstruction prevents the clotting complications that can kill a free flap, in a 2026 retrospective analysis. The team reviewed all such reconstructions at their institution from January 2018 to June 2024. They compared patients who received a single intraoperative bolus of 2,000 units of unfractionated heparin with those who did not.

The series covered 114 patients and 141 breasts, split into 66 patients in the heparin cohort and 48 controls. Complication rates did not differ in any window: intraoperative events, acute complications within four days, and delayed ones beyond that point were statistically indistinguishable. Thrombosis and hematoma risks specifically were comparable. The authors read the results as reassuring on safety but negative on efficacy: the heparin bolus neither reduced clotting events nor provoked bleeding. The single intraoperative dose, as given, is not where clot prevention succeeds or fails in this operation.

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Source: https://europepmc.org/article/MED/PMC13400039