This single-center retrospective study included patients who underwent free-flap transfer performed by the same surgeon; antithrombotic therapy was the only variable. The sample included 11 patients (group A) who received heparin and prostaglandin E1 (PGE1) postoperatively, 23 patients (group B) who did not receive heparin but received PGE1 postoperatively, and 24 patients (group C) who did not receive either heparin or PGE1 postoperatively. Patient background characteristics were not significantly different among the groups. The incidences of arterial occlusion, venous occlusion, postoperative bleeding, and partial necrosis were not significantly different among the groups (arterial occlusion: one patient in group A, none in group B, and one patient in group C, p = 0.5; venous occlusion: none in group A, two patients in group B, and one patient in group C, p = 0.79; postoperative bleeding: three patients in group A, two patients in group B, and two patients in group C, p = 0.29; partial necrosis: none in group A, three patients in group B, and three patients in group C, p = 0.63) . These results suggest that heparin and PGE1 administration do not improve impaired blood flow following free-flap transfer. Considering the potential complications, these drugs may be unnecessary.
