The effect of fondaparinux versus enoxaparin in the survival of a congested skin flap in a rabbit model.

Abstract

The purpose of this study was to evaluate the effects of fondaparinux, a selective antithrombin III agonist, in comparison to the low-molecular-weight heparin enoxaparin in the survival of a congested skin flap. Eighteen axial-pattern auricular flaps were performed on rabbits using a well-described congested flap model. Animals were randomized into 2 treatment groups, enoxaparin (n = 6) and fondaparinux (n = 6), and a control group (n = 6) that received no treatment. Skin flap survival area was measured postoperatively at 7 and 14 days. The groups that received fondaparinux and enoxaparin had similar mean flap survival areas and were not statistically different. However, both treatment groups significantly increased flap survival compared with controls (P < 0.014). Fondaparinux, like enoxaparin, significantly improves survival of congested flaps in rabbits. Its use instead of enoxaparin may be warranted, given that it eliminates the risk of heparin-induced thrombocytopenia. Further study in humans is warranted.