Profilaxia tromboembólica farmacológica e por compressão pneumática intermitente em 563 casos consecutivos de abdominoplastia

Abstract

Pharmacologic and intermittent pneumatic compression thromboembolic prophylaxis in 563 consecutives abdominoplasty cases Pharmacologic and intermittent pneumatic compression thromboembolic prophylaxis in 563 consecutives abdominoplasty cases Profilaxia tromboembólica farmacológica e por compressão pneumática intermitente em 563 casos consecutivos de abdominoplastia ABSTRACT Background: Abdominoplasty is a common cosmetic surgery and is subject to the same complications as any surgical procedure, including thromboembolic phenomena. The aim of this study was to assess the incidence of complications in consecutive abdominoplasties performed over a 3-year period, to identify risk factors for the complications, and to compare the efficacy of two protocols for prevention of thromboembolism. Methods: A retrospective study was conducted of 563 patients who underwent isolated abdominoplasty or abdominoplasty combined with additional cosmetic surgeries between March 2008 and April 2011. All patients received thromboembolism prophylaxis using either pharmacological (enoxaparin; 357 patients) or mechanical (intermittent pneumatic compression, IPC; 206 patients) protocols. Results: Of the 563 patients studied, 4 (0.7%) were male (0.7%) and 559 (99.3%) were female. The patients underwent isolated abdominoplasty (201; 35.7%) or abdominoplasty combined with other procedures (362; 64.3%). The patient groups receiving pharmacological and mechanical prophylaxis presented similar demographic and clinical characteristics and had similar risk factors for thromboembolic events. The incidence of complications in the patient groups undergoing pharmacological versus mechanical prophylaxis were: hematoma (5.6% vs. 10.7%), infection (2.2% vs. 2.4%), dehiscence (3.1% vs. 1.9%), seroma (2.2% vs. 2.4%), and deep vein thrombosis/pulmonary embolism (0.6% vs. 0.5%). There were no statistically significant differences in the incidence of complications between the two groups. Conclusion: The incidence of complications in 563 consecutive cases of abdominoplasty was similar to that reported in the literature. The pharmacological and mechanical protocols for thromboembolic prophylaxis in abdominoplasty were equally effective.

Venous thromboembolism in abdominoplasty: a prevention protocol

“…Therefore, all patients undergoing this procedure should receive some type of pharmacological thromboembolic prophylaxis. 2,3 The pharmacological therapy employed in our service consisted of the use of enoxaparin at a dose of 40 mg/day for 5 days, the first dose being performed during anesthetic induction. Starting on day 6, patients were given rivaroxaban at a dose of 10 mg/day for 10 days.…”

“…Studies have shown that abdominoplasty alone, when not combined with any other procedure, is associated with a rate of 0.1% to 1.1% for DVT, 0.34% to 1.1% for PTE, and 0.5 to 8% for hematoma. 2,4,5 When combined surgery is performed, these values increase significantly.¹ In cases of death due to PTE, specific data for abdominoplasties are not found in the literature, but a mortality rate of 0.1 to 0.8% is reported for general surgery patients.…”

Fatores de risco e métodos de profilaxia para o tromboembolismo venoso nos pacientes hospitalizados / Risk factors and prophylaxis of methods for venous thromboembolism in hospitalized patient

“…Ele é capaz de aumentar a velocidade de fluxo venoso femoral em mais de 200%. Além do aumento do fluxo venoso, essa compressão promove a fibrinólise endógena ao estimular o endotélio vascular, logo é eficaz para diminuir a estase sanguínea por meio da compressão repetidamente dos membros inferiores, aumentando o retorno venoso e reduzindo estados de hipercoagulabilidade, o que estimula a atividade fibrinolítica endógena (21,43) .…”