SynthesisPloS one2014
Effect of heparin on prevention of flap loss in microsurgical free flap transfer: a meta-analysis.
Synthesis in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 33 citations in OpenAlex.
- Does Intraoperative Heparin Administration Reduce Postoperative Complications in Deep Inferior Epigastric Perforator Flap Breast Reconstruction?Plastic and reconstructive surgery. Global open · 2026Article
- Mythbusters in Microsurgery: Evaluating Evidence and Debunking Dogma-A Practical Review: Part I.Plastic and reconstructive surgery. Global open · 2026Review
- Article
- Global Variations in Surgical Techniques and Postoperative Care for Radial Forearm Free Flap (RFFF) in Head & Neck Surgery: A Cross-Sectional International Survey.Journal of clinical medicine · 2025Article
- Efficacy of Batroxobin on Ischemia-Reperfusion Injury in Epigastric Artery Island Flaps in Rats.Plastic and reconstructive surgery. Global open · 2025Article
- Deep inferior epigastric perforator flap breast reconstruction in patients with Raynaud's disease: a case series and literature review.Journal of surgical case reports · 2025Article
- Current Modalities in Soft-Tissue Reconstruction and Vascularized Adipose Engineering.Biomolecules · 2025Review
- Evidence-Based Approaches to Anticoagulation in Reconstructive Microsurgery-A Systematic Literature Review.Life (Basel, Switzerland) · 2024Review
- Post-reconstruction Free Flap Complications After Oral Cancer Ablation.Journal of maxillofacial and oral surgery · 2023Review
- Chemoprophylaxis and Management of Venous Thromboembolism in Microvascular Surgery.Seminars in plastic surgery · 2023Review
- Multidisciplinary Practice Variations of Anti-Thrombotic Strategies for Free Tissue Transfers.Plastic surgery (Oakville, Ont.) · 2022Article
- Leech Therapy Protects Free Flaps against Venous Congestion, Thrombus Formation, and Ischemia/Reperfusion Injury: Benefits, Complications, and Contradictions.The archives of bone and joint surgery · 2022Review
- Free flap thrombosis in patients with hypercoagulability: A systematic review.Archives of plastic surgery · 2019Article
- Thromboprophylaxis in Head and Neck Microvascular Reconstruction.Craniomaxillofacial trauma & reconstruction · 2018Review
- Towards standardization of training and practice of reconstructive microsurgery: an evidence-based recommendation for anastomosis thrombosis prophylaxis.European journal of plastic surgery · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The effectiveness of heparin for thromboprophylaxis during microvascular free flap transfer is uncertain. The purpose of this meta-analysis was to determine the effect of heparin on the prevention of flap loss in microsurgical free flap transfer.A search of PubMed, Cochrane databases, and Google Scholar using combinations of the search terms heparin, free flap, flap loss, free tissue transfer was conducted on March 15, 2013. Inclusion criteria were: 1) Prospective randomized trials. 2) Retrospective, non-randomized studies. 3) Patients received free tissue transfer. Flap loss rate was used to evaluate treatment efficacy. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated and compared between therapies. Four studies meet the criteria for analysis and were included. Two studiescompared aspirin and heparin, and the ORs of the 2 studies were 1.688 and 2.087. The combined OR of 2.003 (95% CI 0.976-4.109, p = 0.058) did not indicate any significant difference between heparin and aspirin therapies. Two studiescompared high and low doses of dalteparin/heparin therapies, and the ORs of the 2 studies were 4.691 and 11.00. The combined OR of 7.810 (95% CI 1.859-32.808, p = 0.005) revealed a significant difference indicating that high dose dalteparin or heparin therapy is associated with a greater flap loss rate than low dose therapy. Heparin and aspirin prophylaxis are associated with similar flap loss rates after free flap transfer, and high dose dalteparin or heparin therapy is associated with a greater flap loss rate than low dose therapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.