Heparin Alone vs. Heparin-Aspirin Combo in Free Flap Survival

The objective of this randomized clinical trial is to evaluate the efficacy of heparin alone vs compared to combination therapy of Heparin-Aspirin in enhancing free flap survival in patients undergoing reconstructive surgery. Participants will be randomly assigned to one of two groups: one receiving standard heparin therapy and the other receiving a combination therapy that includes heparin and other agents. The primary outcome will be the survival rate of the free flap, assessed at multiple intervals after surgery. Secondary outcomes will to assess the incidence of flap thrombosis, bleeding complications, re-operation in free flap surgeries and overall patient outcomes in both groups. Ethical approval will be obtained, and informed consent will be required from all participants. This trial seeks to provide robust evidence on the potential benefits of combination therapy over heparin alone in free flap survival, potentially informing future clinical guidelines.

Inclusion criteria

• Patients undergoing free flap surgery
• Age between 18 and 70 years

Exclusion criteria

• Known hypersensitivity to heparin or aspirin
• History of bleeding disorders
• Concurrent use of other anticoagulant or antiplatelet medications
• Severe renal or hepatic impairment
• Preoperative use of aspirin that could not be stopped five days before surgery due to a higher risk of cardiac-related complications.