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

NCT06512233 — Not applicable, Unknown, 126 participants, Aga Khan University

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Dual Therapy Dilemma: Heparin Alone vs. Heparin-Aspirin Combo in Free Flap Survival

RegistryNCT06512233
StatusUnknown
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: single, treatment
Enrollment126 (Estimated)
SponsorAga Khan University (Other)
ConditionsComplication,Postoperative
InterventionsLMW Heparin 5000 U/ML-Aspirin 75 MG, LMW Heparin 5000 U/ML (Drug)
Datesstart 2025-01-01 (estimated), primary completion 2025-12-01 (estimated), completion 2025-12-01 (estimated), first posted 2024-07-22, last updated 2024-07-23
Locations1 site in Pakistan

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-Summary

This randomized clinical trial aims to compare the effectiveness of heparin alone versus combination therapy of Heparin- Aspirin in improving free flap survival in patients undergoing reconstructive surgery. Participants will be randomly assigned to receive either heparin or a combination therapy, and the primary outcome measure will be the survival rate of the free flap at various time points post-surgery

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+Detailed description

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.

+Arms and interventions

ArmTypeInterventionsDescription
LMW Heparin 5000 U/ML-Aspirin 75 MGActive comparatorDrug: LMW Heparin 5000 U/ML-Aspirin 75 MGPatients will receive 5000 unit of low molecular weight heparin subcutaneously once daily along with tablet aspirin 75 MG once daily, for additional thromboprophylaxis for free flap. The flaps of these patients will be monitored as standard clinical examination and outcome will be recorded until 4th post operative day.
LMW Heparin 5000 U/MLActive comparatorDrug: LMW Heparin 5000 U/MLPatients will receive 5000 unit of low molecular weight heparin subcutaneously once daily according to institutional protocol as routine practice for prevention of deep venous thrombosis in post operative period. The flaps of these patients will be monitored as standard clinical examination and outcome will be recorded until 4th post operative day.
  • LMW Heparin 5000 U/ML-Aspirin 75 MG (Drug): Arm 1
  • LMW Heparin 5000 U/ML (Drug): Arm 2

+Outcome measures

Primary outcomes

  • Free Flap Survival Rate [two hourly for 1st 24 hours and then three hourly for next 48 hours and four hourly for next 72 hours and onwards.]: Percentage of patients with successful survival of the free flap grafts at specified time points post-surgery

Secondary outcomes

  • flap thrombosis, bleeding complications, re-operation in free flap surgeries and overall patient outcomes in both groups [30 days post-surgery]: Number of participants experiencing complications requiring medical or surgical intervention within the first 30 days post-surgery.

+Eligibility

Sex: All, ages: 18 Years to 70 Years, accepts healthy volunteers

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.

+Locations (1)

FacilityCityCountryStatus
Aga Khan UniversityKarachi, SindhPakistan

+Investigators