OBJECTIVES: Free flaps are widely used to reconstruct head and neck defects. Despite the improvement in the surgical techniques and the surgeons’ experiences, flap failures still occur due to thrombotic occlusion after small vessels anastomosis. To reduce the possibility of flap loss as a result of thrombotic occlusion, various anticoagulants have been used. In this study we decided to evaluate a new protocol for anticoagulation therapy and its effect on flap survival and complications. METHODS: In this interventional study, 30 patients with head and neck cancer underwent surgical defects were reconstructed by microvascular free flap between 2013 and 2014. In the postoperative period patients have taken aspirin (100 mg/day) for 5 days and enoxaparin (40 mg/day subcutaneously) for 3 days. The flap survival was followed for three weeks. RESULTS: Given that there was no complete necrosis or loss of flap, the free flap success rate was as much as 100%. The need for re-exploration occurred in 3 patients (10%). Only in one patient the need for re-exploration was due to problem in venous blood flow. CONCLUSION: The aspirin-enoxaparin short-term protocol may be a good choice after free flap transfer in reconstruction of head and neck surgical defects.
Anticoagulants ; Aspirin ; Enoxaparin ; Free Tissue Flaps* ; Head and Neck Neoplasms ; Head* ; Humans ; Methods* ; Neck* ; Necrosis ; Postoperative Period

To explore the spatial accumulation of diseases and their aggravating factors are essential in all public health. This study attempts to use geographic information system (GIS) to provide more information about the incidence and future of anthrax. Methods: Patients were diagnosed with anthrax in Kurdistan Province from 2009 to 2016. Data was then exported into ArcGIS software version 9 and the required layers for years and areas were added.Final map for each year was drawn up, pointing out the hot spots and predicting its future pattern. Results: Most cases were reported in females (57 cases, 54.80 %), and the lower body limbs were most affected (63 cases, 60.57%). The highest numbers of incidences were related to the cities of Marivan, Saqez and Divandareh, with more concentration in the central parts of the province, rather than borderline areas. The highest percentage of the probable incidence of the disease was in Sanandaj (57.74%) with a potential susceptible area of 1 729.12 km