BACKGROUND: The purpose of this study was to stratify plastic surgery patients into venous thromboembolism risk categories; identify patients at highest risk for venous thromboembolism; and quantify rates of postoperative all-cause mortality, venous thromboembolism, and hematoma/bleeding on different forms of thromboprophylaxis. Furthermore, this study aimed to determine the compliance and average duration of outpatient chemoprophylaxis. METHODS: A retrospective cohort study was carried out on a single plastic surgeon's experience. Venous thromboembolism risk stratification identified patients at highest risk. Records were reviewed for regimen of thromboprophylaxis and for occurrences of all-cause mortality, venous thromboembolism, and hematoma/bleeding. Outpatient compliance and duration of low-molecular-weight heparin chemoprophylaxis was also documented. RESULTS: During the study time period, 173 operations involved 120 patients at highest risk for venous thromboembolism. Among highest risk patients, one (0.8 percent) suffered a pulmonary embolism, eight (6.7 percent) experienced a deep vein thrombosis, and 15 (12.5 percent) endured a hematoma/bleed. Thirteen of 14 outpatients (92.9 percent) were compliant with low-molecular-weight heparin and remained on chemoprophylaxis for an average of 7.4 days. CONCLUSIONS: Mechanical prophylaxis plus subcutaneous heparin (unfractionated or low-molecular-weight heparin) conferred a statistically significant reduction in the rate of venous thromboembolism without a significant increase in bleeding versus mechanical prophylaxis alone. Subgroup analysis of patients placed on mechanical prophylaxis plus low-molecular-weight heparin revealed similar statistically significant findings. Outpatients placed on low-molecular-weight heparin chemoprophylaxis demonstrated excellent compliance and comfort with self-administration. Therefore, the use of mechanical prophylaxis supplemented with low-molecular-weight heparin is strongly recommended as the first-line regimen for thromboprophylaxis in plastic surgery patients at highest risk for venous thromboembolism.
BACKGROUND: The purpose of this study was to stratify plastic surgery patients into venous thromboembolism risk categories; identify patients at highest risk for venous thromboembolism; and quantify rates of postoperative all-cause mortality, venous thromboembolism, and hematoma/bleeding on different forms of thromboprophylaxis. Furthermore, this study aimed to determine the compliance and average duration of outpatient chemoprophylaxis. METHODS: A retrospective cohort study was carried out on a single plastic surgeon's experience. Venous thromboembolism risk stratification identified patients at highest risk. Records were reviewed for regimen of thromboprophylaxis and for occurrences of all-cause mortality, venous thromboembolism, and hematoma/bleeding. Outpatient compliance and duration of low-molecular-weight heparin chemoprophylaxis was also documented. RESULTS: During the study time period, 173 operations involved 120 patients at highest risk for venous thromboembolism. Among highest risk patients, one (0.8 percent) suffered a pulmonary embolism, eight (6.7 percent) experienced a deep vein thrombosis, and 15 (12.5 percent) endured a hematoma/bleed. Thirteen of 14 outpatients (92.9 percent) were compliant with low-molecular-weight heparin and remained on chemoprophylaxis for an average of 7.4 days. CONCLUSIONS: Mechanical prophylaxis plus subcutaneous heparin (unfractionated or low-molecular-weight heparin) conferred a statistically significant reduction in the rate of venous thromboembolism without a significant increase in bleeding versus mechanical prophylaxis alone. Subgroup analysis of patients placed on mechanical prophylaxis plus low-molecular-weight heparin revealed similar statistically significant findings. Outpatients placed on low-molecular-weight heparin chemoprophylaxis demonstrated excellent compliance and comfort with self-administration. Therefore, the use of mechanical prophylaxis supplemented with low-molecular-weight heparin is strongly recommended as the first-line regimen for thromboprophylaxis in plastic surgery patients at highest risk for venous thromboembolism.
Authors: Christopher J Pannucci; Steven H Bailey; George Dreszer; Christine Fisher Wachtman; Justin W Zumsteg; Reda M Jaber; Jennifer B Hamill; Keith M Hume; J Peter Rubin; Peter C Neligan; Loree K Kalliainen; Ronald E Hoxworth; Andrea L Pusic; Edwin G Wilkins Journal: J Am Coll Surg Date: 2010-11-18 Impact factor: 6.113
Authors: Christopher J Pannucci; Christine Fisher Wachtman; George Dreszer; Steven H Bailey; Pamela R Portschy; Jennifer B Hamill; Keith M Hume; Ronald E Hoxworth; Loree K Kalliainen; J Peter Rubin; Andrea L Pusic; Edwin G Wilkins Journal: Plast Reconstr Surg Date: 2012-01 Impact factor: 4.730
Authors: Christopher J Pannucci; Reda M Jaber; Justin M Zumsteg; Vlad Golgotiu; Lisa M Spratke; Edwin G Wilkins Journal: Plast Reconstr Surg Date: 2011-11 Impact factor: 4.730
Authors: Julio A Clavijo-Alvarez; Christopher J Pannucci; Adam J Oppenheimer; Edwin G Wilkins; J Peter Rubin Journal: Ann Plast Surg Date: 2011-03 Impact factor: 1.539
Authors: Christopher J Pannucci; Amy Shanks; Marc J Moote; Vinita Bahl; Paul S Cederna; Norah N Naughton; Thomas W Wakefield; Peter K Henke; Darrell A Campbell; Sachin Kheterpal Journal: Ann Surg Date: 2012-06 Impact factor: 12.969