Evaluating the Effect of Compound Solution of Papaverine, Lidocaine, and Heparin on Vasodilation of Vessels for Microvascular Anastomosis

Topical application of 3 vasodilators has been used in 19 patients and 20 free flaps to facilitate microvascular anastomosis. The author by hit and trial struck with a formula of one ampule of heparin, two ampules of papaverine, and five ampules of lidocaine for topical application just before microvascular anastomosis. This solution was tested both subjectively as an intragroup operating team for the ease of anastomosis, and objectively the outcome of microvascular flap survival was assessed. A sample of 20 consecutive free flaps was included on accrual and assessed for ease of operating under aided vision and flap survival. The solution was poured on recipient and donor site until the vessels were flooded for at least 15 min for its full vasodilatory effect. Vessels’ diameters were measured before and after using the solution by a caliper and a micrometer. A total of 40 arteries and 46 veins were measured at recipient and donor sites. Mean diameter of artery increased from 3.07 to 3.77 mm, a 22.80% increase ( p value < 0.001). Mean diameter of vein increased from 3.45 to 3.93 mm, a 13.62% increase ( p value < 0.001). HM125 is an effective vasodilatory solution—HM is the initials of senior author’s name, and 125 stand for one ampule heparin, two papaverine, and five ampules of lidocaine, respectively. This is a pilot study of this innovative concoction for vasodilatation for microvascular anastomosis which needs to be externally verified by other users both in case series analyses and trials.