Practical guidelines for venous thromboembolism chemoprophylaxis in elective plastic surgery

Plast Reconstr Surg. 2015 Feb;135(2):413-23. doi: 10.1097/PRS.0000000000000908.

Abstract

Venous thromboembolism is a complication that results in a wide range of patient morbidity and potential mortality. Awareness of this risk has led to recent advances in both the perioperative planning of chemoprophylaxis and the stratification of risk factors. Together, these modifications have helped reduce the incidence and severity of venous thromboembolism. Major hospital-based initiatives to decrease the overall rate of venous thromboembolism and halt the progression of severe complications, including pulmonary embolism, are one such change. However, surgeon reluctance based on the potential for bleeding complications continues to decrease the use of these algorithms, despite several reports that fail to demonstrate an increase in postoperative bleeding or hematoma formation with chemoprophylaxis administered at appropriate dosages. This review summarizes the current recommendations and procedure-specific strategies for venous thromboembolism prophylaxis with a focus on elective or aesthetic surgery-based procedures. The authors will recommend which patients are appropriate, what doses are appropriate, and when the doses should be administered for aesthetic and elective surgery.

MeSH terms

  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use*
  • Bariatric Surgery
  • Blood Loss, Surgical
  • Compression Bandages
  • Contraceptives, Oral, Hormonal / adverse effects
  • Elective Surgical Procedures*
  • Fibrinolytic Agents / adverse effects
  • Fibrinolytic Agents / therapeutic use*
  • Hormone Replacement Therapy / adverse effects
  • Humans
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control*
  • Practice Guidelines as Topic*
  • Preanesthetic Medication
  • Pulmonary Embolism / etiology
  • Pulmonary Embolism / prevention & control
  • Reconstructive Surgical Procedures*
  • Risk Reduction Behavior
  • Severity of Illness Index
  • Thrombophilia / complications
  • Venous Thromboembolism / etiology
  • Venous Thromboembolism / prevention & control*

Substances

  • Anticoagulants
  • Contraceptives, Oral, Hormonal
  • Fibrinolytic Agents