Prospective Study on the Role of Intravenous Unfractionated Heparin Following Digital Replantation and Revascularization
Amputation; Traumatic, Hand
About this trial
This is an interventional treatment trial for Amputation; Traumatic, Hand focused on measuring Replantation, Revascularization, Unfractionated heparin, Finger
Eligibility Criteria
Inclusion Criteria:
- All replantation and revascularization patients who are accepted into the CEVARMU program at the Centre hospitalier de l'Université de Montréal
Exclusion Criteria:
- Patients on anticoagulants, other than ASA, prior to admission (i.e. Coumadin, Eliquis, Pradaxa, Plavix, or similar medications)
- Patients with a contraindication for heparin (e.g. coagulopathy, acute ulcers, thrombocytopenia, severe liver damage, shock)
- Patients who suffered an amputation in the level of the carpal tunnel and proximal to it
- Patients who experienced a degloving injury
Sites / Locations
- CHUMRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Sham Comparator
Intravenous unfractionated heparin
Control
Administration of intravenous unfractionated heparin according to the Centre hospitalier de l'Université de Montréal (CHUM) deep vein thrombosis (DVT) protocol for 5 days after vascular anastomosis. A bolus will be administered intraoperatively based on the patient's weight. Dosages will be adjusted according to the activated partial thromboplastin time (aim for an APTT of 50-70), which will be measured 6 hours after the start of the protocol and after every dosage adjustment or every morning at 6 a.m. if no adjustments were made in the last 6 hours.
No administration of intravenous unfractionated heparin. These patients receive 5000 IU BID of heparin subcutaneously, as a standard post-operative protocol for all in-patients. The control group receives sham bolus intraoperatively of normal saline and a post-operative normal saline infusion at a fixed dose through an infusion pump to mimic IV heparin infusion.