Postoperative Venous Thromboembolism Prophylaxis Utilizing Enoxaparin Does Not Increase Bleeding Complications After Abdominal Body Contouring Surgery
| Autor: | Sami U. Khan, Muntazim Mukit, Gabriel M. Klein, Vasileios Vasilakis, Michael Trostler, Jocellie Marquez, Christopher J. Pannucci, Alexander B. Dagum |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Aftercare 030230 surgery Preoperative care 03 medical and health sciences Postoperative Complications 0302 clinical medicine Panniculectomy medicine Humans Enoxaparin Abdominoplasty business.industry Anticoagulants Venous Thromboembolism General Medicine Body Contouring Patient Discharge Surgery Plastic surgery Regimen 030220 oncology & carcinogenesis Liposuction Body contouring Chemoprophylaxis business |
| Zdroj: | Aesthetic Surgery Journal. 40:989-995 |
| ISSN: | 1527-330X 1090-820X |
| DOI: | 10.1093/asj/sjz274 |
| Popis: | Background Venous thromboembolism (VTE) chemoprophylaxis warrants an individualized, risk-stratified approach, and constitutes a relatively controversial topic in plastic surgery. Objectives The aim of this study was to determine the safety of a 7-day postoperative enoxaparin regimen for VTE prophylaxis compared with a single preoperative dose of heparin in abdominal body contouring surgery. Methods This single-institution pre-post study investigated the safety of a 7-day enoxaparin postoperative regimen in abdominal body contouring procedures performed by a single surgeon from 2007 to 2018. Four procedures were included: traditional panniculectomy, abdominoplasty, fleur-de-lis panniculectomy, and body contouring liposuction. Group I patients received a single dose of 5000 U subcutaneous heparin in the preoperative period, and no postoperative chemical prophylaxis was administered. Group II patients received 40 mg subcutaneous enoxaparin in the immediate preoperative period, then once daily for 7 days postoperatively. Results A total of 195 patients were included in the study, 66 in Group I and 129 in Group II. The groups demonstrated statistically similar VTE risk profiles, based on the 2005 Caprini risk-assessment model. There were no statistically significant differences in the 2 primary outcomes: postoperative bleeding and VTE events. Group I patients had higher reoperation rates (22.7% vs 10.1%, P = 0.029), which was secondary to higher rates of revision procedures. Conclusions A 7-day postoperative course of once-daily enoxaparin for VTE risk reduction in abdominal body contouring surgery does not significantly increase the risk of bleeding. Implementation of this regimen for postdischarge chemoprophylaxis, when indicated following individualized risk stratification, is appropriate. Level of Evidence: 4 |
| Databáze: | OpenAIRE |
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