Venous thromboembolism in plastic surgery: the current state of evidence in risk assessment and chemoprophylactic options.
Venous thromboembolism in plastic surgery: the current state of evidence in risk assessment and chemoprophylactic options.
- 2019
The application of venous thromboembolism (VTE) prophylaxis has been the topic of intense debate in plastic surgery. The overall incidence of VTE is low in plastic surgery patients as compared to other surgical subspecialties but may be higher in the inpatient rather than outpatient plastic surgery populations. The Caprini Risk Assessment Model is the most highly studied and validated tool to assess VTE risk in plastic surgery patients. However, the Caprini model lacks procedure-specific risk assessment and patient-specific risk factor calculations. Due to these limitations, such as the low incidence and the heterogeneous nature of the specialty, trials lacked the power to capture proof of benefit, except in the highest-risk inpatient population. The emerging use of aspirin and novel oral anticoagulants may provide an alternative, as noninferiority in terms of efficacy and safety has been demonstrated in other fields. In this review, the authors intend to summarize the current state of evidence for prevention and explore the modalities available for prophylaxis, including novel oral anticoagulants.
English
2000-6764
10.1080/2000656X.2019.1650057 [doi]
*Anticoagulants/tu [Therapeutic Use]
*Chemoprevention
*Reconstructive Surgical Procedures/ae [Adverse Effects]
*Risk Assessment
*Venous Thromboembolism/pc [Prevention & Control]
Administration, Oral
Anticoagulants/pd [Pharmacology]
Aspirin/pd [Pharmacology]
Aspirin/tu [Therapeutic Use]
Heparin, Low-Molecular-Weight/pd [Pharmacology]
Heparin, Low-Molecular-Weight/tu [Therapeutic Use]
Humans
Incidence
Postoperative Complications
Pyrazoles/pd [Pharmacology]
Pyrazoles/tu [Therapeutic Use]
Pyridones/pd [Pharmacology]
Pyridones/tu [Therapeutic Use]
Rivaroxaban/pd [Pharmacology]
Rivaroxaban/tu [Therapeutic Use]
MedStar Health Research Institute
MedStar Washington Hospital Center
Surgery/Plastic Surgery
Journal Article
The application of venous thromboembolism (VTE) prophylaxis has been the topic of intense debate in plastic surgery. The overall incidence of VTE is low in plastic surgery patients as compared to other surgical subspecialties but may be higher in the inpatient rather than outpatient plastic surgery populations. The Caprini Risk Assessment Model is the most highly studied and validated tool to assess VTE risk in plastic surgery patients. However, the Caprini model lacks procedure-specific risk assessment and patient-specific risk factor calculations. Due to these limitations, such as the low incidence and the heterogeneous nature of the specialty, trials lacked the power to capture proof of benefit, except in the highest-risk inpatient population. The emerging use of aspirin and novel oral anticoagulants may provide an alternative, as noninferiority in terms of efficacy and safety has been demonstrated in other fields. In this review, the authors intend to summarize the current state of evidence for prevention and explore the modalities available for prophylaxis, including novel oral anticoagulants.
English
2000-6764
10.1080/2000656X.2019.1650057 [doi]
*Anticoagulants/tu [Therapeutic Use]
*Chemoprevention
*Reconstructive Surgical Procedures/ae [Adverse Effects]
*Risk Assessment
*Venous Thromboembolism/pc [Prevention & Control]
Administration, Oral
Anticoagulants/pd [Pharmacology]
Aspirin/pd [Pharmacology]
Aspirin/tu [Therapeutic Use]
Heparin, Low-Molecular-Weight/pd [Pharmacology]
Heparin, Low-Molecular-Weight/tu [Therapeutic Use]
Humans
Incidence
Postoperative Complications
Pyrazoles/pd [Pharmacology]
Pyrazoles/tu [Therapeutic Use]
Pyridones/pd [Pharmacology]
Pyridones/tu [Therapeutic Use]
Rivaroxaban/pd [Pharmacology]
Rivaroxaban/tu [Therapeutic Use]
MedStar Health Research Institute
MedStar Washington Hospital Center
Surgery/Plastic Surgery
Journal Article