Influence of anticoagulant concomitant medication on wound healing: Analysis of a multicentre cohort of 212 patients with a uniform wound model.

Aims: Various factors can impair wound healing by disrupting key stages of the process. This study evaluates the impact of concomitant anticoagulant medication on wound healing in a cohort of 212 patients.

Methods: Data from 2 open-label, blindly evaluated, prospective, randomized, multicentre phase III trials (n = 212) were analysed. Healing durations of patients taking anticoagulants were compared to a control group (split-thickness skin graft donor site halves treated with standard moist wound dressing). Kaplan-Meier estimators and multivariable Cox regression were applied.

Results: Kaplan-Meier analysis demonstrated significantly accelerated wound healing in patients treated with enoxaparin or nadroparin. Among monotherapies, 75% of patients on enoxaparin achieved wound closure within 16.5 days (95% confidence interval [CI]: 14-21), and those on nadroparin within 15 days (95% CI: 11.5-19), compared to 24 days (95% CI: 20-28) in patients receiving other anticoagulants (log-rank test: P < .001). Cox regression confirmed a significantly faster healing rate with enoxaparin or nadroparin (hazard ratio = 1.50, 95% CI: 1.02-2.19, P = .039).

Conclusion: Enoxaparin and nadroparin may enhance wound healing, whereas phenprocoumon, acetylsalicylic acid, and certain low-molecular-weight heparins (certoparin, tinzaparin, dalteparin, bemiparin) appear to delay wound healing. Anticoagulant monotherapy with enoxaparin or nadroparin should be considered postoperatively when feasible.