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J Reconstr Microsurg 2021; 37(08): 694-703
DOI: 10.1055/s-0041-1726028
Original Article

The Influence of Topically Administered Heparin on Peripheral Microcirculation of the Skin: A Double-Blind, Randomized, Controlled Preliminary Study on 50 Healthy Subjects

Authors

  • Markus Denzinger 

    1   Department of Pediatric Surgery and Orthopedics, St. Hedwig, University Medical Center Regensburg, Regensburg, Germany

  • Manuel Held

    2   Clinic for Plastic, Reconstructive, Hand and Burn Surgery, BG Trauma Center, Tuebingen, Germany

  • Amro Amr

    3   Department of Plastic Surgery, Microsurgery and Reconstructive Breast Surgery, Marien Hospital, Stuttgart, Germany

  • Sabrina Krauß

    2   Clinic for Plastic, Reconstructive, Hand and Burn Surgery, BG Trauma Center, Tuebingen, Germany

  • Dominik Bender

    2   Clinic for Plastic, Reconstructive, Hand and Burn Surgery, BG Trauma Center, Tuebingen, Germany

  • Adrien Daigeler

    2   Clinic for Plastic, Reconstructive, Hand and Burn Surgery, BG Trauma Center, Tuebingen, Germany

  • Andrea Wenger

    4   Clinic for Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, Klinikum Traunstein, Traunstein, Germany
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Abstract

Background Venous thrombosis is the most common cause of flap failure in the first days after surgery. Although heparin is one of the most important antithrombotic substances and is implemented in the therapy of various diseases, there are only a few studies addressing its topical administration in the field of flap surgery. Especially, very little is known about the effects of topical heparin and its impact on microcirculation. In this study we evaluated to what extent topically administered heparin influences skin microcirculation (capillary venous oxygen saturation SO2, blood filling of microvessels, blood flow, and velocity) in healthy subjects.

Methods Skin perfusion parameters on the forearm were measured with the O2C device in a double-blinded, controlled, and randomized study with 50 healthy subjects after administration of heparin ointment in three different concentrations and a control ointment (dexpanthenol).

Results Topically administrated heparin slightly increased SO2 (max. 187 ± 285 SD or standard deviation % vs. 145 ± 129 SD %), flow (max. 264 ± 427 SD % vs. 151.74 ± 111 SD %), and velocity (max. 153 ± 149 SD % vs. 122 ± 56 SD %) after an incubation time of 60 minutes in comparison to control. No statistically significant difference could be detected regarding heparin concentration.

Conclusion As a first important step in possible future implementing of heparin as a topical administration in flap surgery, our data—although not statistically significant—indicate that heparin can improve microcirculation (SO2, flow) in healthy subjects. Nevertheless, further research in subjects with impaired microcirculation is necessary.

Keywords

heparin - microcirculation - blood flow - free flaps - O2C - perfusion


Publication History

Received: 20 September 2020

Accepted: 27 January 2021

Article published online:
31 March 2021

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