Preoperative management of blood thinning agents during cutaneous surgery: The need for an individualized approach

Gajebasia, Sareena; Kerr, Ron; Affleck, A.

doi:10.1016/j.jaad.2020.08.075

Cited by 2 publications

(2 citation statements)

References 3 publications

(2 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Kawaguchi et al [ 15 ] reported the average blood loss of the arthroscopic rotator to be 355.5 ± 191.2 mL during arthroscopic rotator cuff repair. Since there is no feasible method to accurately record surgery-related blood loss due to incomplete collection of irrigation fluid, and hypervolemia caused by perioperative fluid management can subsequently lead to blood dilution, [ 16 , 17 ] the surgery-related blood loss can more practically be calculated out based upon the change of perioperative HCT level. In the present study, the blood test was conducted on the first and third days after the operation, the changes in hemoglobin and HCT before and after the operation were counted, and the total blood volume and total blood loss were estimated using the Nadler [ 18 ] and Gross [ 19 ] equations.…”

Section: Discussionmentioning

confidence: 99%

Analysis of risk factors for procedure-related hemorrhage in rotator cuff repair surgery under shoulder arthroscopy

Guo,

Wang

2023

Medicine

View full text Add to dashboard Cite

The present study aims to validate the methods of quantifying blood loss in arthroscopic rotator cuff repair and to investigate the correlation between blood loss and joint pain and joint function recovery. A total of 38 patients with unilateral rotator cuff injuries who underwent shoulder arthroscopy were analyzed in this study. Related information, including age, gender, blood pressure, body mass index (BMI), disease entity, comorbidity, joint release, and operating time, were collected into a spreadsheet. Serum hemoglobin and hematocrit (HCT) levels were obtained before the surgery and on the first and third days after the operation. The visual analog scale (VAS) score and the constant-Murley score of the shoulder joint were evaluated 1 year after the operation. Preoperative blood volume (PBV), red blood cell (RBC), hemoglobin (Hb), and HCT levels were significantly higher than those on postoperative day 1 and day 3. The average surgery-related blood loss was calculated to be 435.2 ± 53.6 mL during the surgery and the first postoperative day and 542.5 ± 63.0 mL during the surgery and the first 3 days after the surgery. The VAS score was significantly reduced 1 year after surgery. The multivariate linear regression analysis showed that joint release was a potential risk factor for predicting blood loss 1 or 3 days postoperatively. The actual blood loss from shoulder arthroscopy may be underestimated. The joint release was regarded as the leading risk factor for blood loss.

show abstract

Section: Discussionmentioning

confidence: 99%

Analysis of risk factors for procedure-related hemorrhage in rotator cuff repair surgery under shoulder arthroscopy

Guo,

Wang

2023

Medicine

View full text Add to dashboard Cite

show abstract

“…7 Many guidelines and reviews heavily support individualizing one's anticoagulation in the perioperative period on a case-bycase basis or simply recommend their continuation throughout the skin surgery period. [8][9][10] This may be due to the definition of skin surgery varying between simple skin biopsies, to flaps and grafts, to MMS.…”

Section: Introductionmentioning

confidence: 99%

Direct oral anticoagulants in skin surgery: a systematic review of their complications and recommendations for perioperative management

Ireland,

Borruso,

Spencer

et al. 2023

Int J Dermatology

View full text Add to dashboard Cite

IntroductionMany patients undergoing cutaneous surgery are prescribed at least one anticoagulant or antiplatelet agent. With the recent emergence of direct oral anticoagulants (DOACs), there is a deficit of knowledge regarding optimal perioperative management. This review aims to evaluate the evidence and risk surrounding management of DOACs in patients undergoing skin surgeries.MethodsSystematic review of EMBASE, Scopus, and PubMed, with inclusion of studies that detailed perioperative management of DOACs in those undergoing skin surgery. Primary outcome measures were perioperative hemorrhagic and thromboembolic complications.ResultsSeven thousand seven hundred and forty‐one abstracts were identified, with 13 articles meeting inclusion criteria. Two studies investigated complication risk associated with DOAC continuation in skin surgery and found an average rate of hemorrhagic complications of 1.74%. Two studies evaluated complications associated with DOAC cessation prior to skin surgery, with a pooled thromboembolic complication rate of 0.15%. Articles comparing continuation and cessation discovered no decreased risk of bleeding with DOAC cessation prior to surgery (P = 0.93). Seven of the 13 articles compared complications in a control vs a DOAC group undergoing cutaneous procedures. Evidence was conflicting but may have suggested a small increase in bleeding risk in those on DOAC therapy.ConclusionOptimal management of anticoagulants perioperatively is difficult because of conflicting information, complicated by advent of novel agents. Risk of hemorrhagic complications with both continuation and interruption of DOAC therapy was low. Perioperative DOAC management can be guided by procedural bleeding and patient clotting risk and can often be continued in minor dermatologic procedures.

show abstract

Preoperative management of blood thinning agents during cutaneous surgery: The need for an individualized approach

Cited by 2 publications

References 3 publications

Analysis of risk factors for procedure-related hemorrhage in rotator cuff repair surgery under shoulder arthroscopy

Analysis of risk factors for procedure-related hemorrhage in rotator cuff repair surgery under shoulder arthroscopy

Direct oral anticoagulants in skin surgery: a systematic review of their complications and recommendations for perioperative management

Contact Info

Product

Resources

About