Abstract
Postoperative management of digital replantation often involves anticoagulation with heparin. To clarify when bolus injection of heparin should be performed for maximum anticoagulation at the time of restarting blood flow, we measured the activated coagulation time ( ACT ) immediately before and after bolus heparin injection in 10 patients who underwent replantation and received bolus heparin during the procedure. The patients ranged in age from 26 to 70 years ( mean : 46 years ). They received 3,000 units of heparin and we evaluated the difference of ACT between before and after bolus injection. Measurements were obtained at 2, 10, 20, and 25 minutes after bolus injection in more than 3 patients. The average ACT was 130.5 seconds before bolus injection. At 2, 10, 20, and 25 minutes after bolus injection, the average ACT was extended by 124.8, 56.8, 17.3, and 46.3 seconds, respectively. Because extension of the ACT was maximal at 2 minutes and was reduced by 10 minutes, the peak extension was presumably between 2 and 10 minutes after bolus injection.
