A Retrospective Study on the Use of a Low-Molecular-Weight Heparin for Thromboembolism Prophylaxis in Large-Volume Liposuction and Body Contouring Procedures

Abstract

This retrospective study was designed to evaluate the efficacy of low-molecular-weight heparin (enoxeparin) as a prophylaxis for venous thromboembolism and deep venous thrombosis (DVT) in the management of large-volume liposuction, added body-contouring procedures, or both. The author present an 18-month experience with the use of this therapy for 291 consecutive patients. All the patients fell into the categories of high risk and highest risk for the development of deep vein thrombosis, embolism, or both. Three patients experienced transient DVT-like symptoms and underwent a thorough workup by an independent highly specialized critical care medical team. The results were found ultimately to be inconclusive for DVT and pulmonary embolism. However, all the patients experienced a complete recovery. The results show a 0% incidence of DVT and pulmonary embolism among patients who received enoxeparin as prophylaxis. The medication did not precipitate major bleeding when administered 1 h after surgery. This study offers the first report that describes the use of enoxeparin in aesthetic surgery for high-risk patients. The authors feel the need to inform their colleagues of the benefits obtained over the past 18 months by incorporating this therapy in large-volume liposuction and extensive body-contouring procedures performed during the same operative session. This study was conducted by a highly experienced surgical team in a fully accredited outpatient facility with established protocols for handling these types of procedures on a daily basis. The authors are optimistic about the results, and the use of enoxeparin is now part of their postoperative regimen in high-risk aesthetic surgery cases.

Venous Thromboembolism Prophylaxis in the Massive Weight Loss Patient

“…Other studies that have used chemoprophylaxis for circumferential abdominoplasty procedures have demonstrated VTE rates of 2.2% to 7.7%. 2,8,37 Although we did see a slightly increased rate in hematoma formation in the group that received chemoprophylaxis, the difference was not statistically different. There was also a decreased rate of transfusion in the chemoprophylaxis group that was similarly nonsignificant.…”

Venous Thromboembolism in Body Contouring

“…This measure has been shown to be both manageable and effective for patients undergoing plastic surgery, and in other fields. 26,[29][30][31] With a high degree of compliance among patients self-administering enoxaparin in all of these studies, extended home venous thromboembolism prophylaxis may represent a safe, cost-effective, risk-reducing intervention. 32,33 To truly assess this, further studies are required.…”

Estudo comparativo entre protocolos para profilaxia da trombose venosa profunda: uma nova proposta

“…Outra possível razão seria a preocupação com sangramentos 11 . A respeito do receio de hemorragias, estudos sugerem não haver aumento significativo do risco de sangramento com uso de heparina de baixo peso molecular (HBPM) ou não-fracionada 11,[18][19][20][21] , contudo, há um risco ligeiramente maior de pequenos sangramentos com o uso da heparina não-fracionada, se comparada com a de baixo peso molecular 11,18 . O uso da HBPM como profilaxia seria, inclusive, não recomendado, devido ao maior risco de sangramento, necessidade eventual de monitorização do TTPA (tempo de tromboplastina parcial ativada) e potencial maior de indução de trombocitopenia 16,22 .…”