The Plastic Surgeon??s Guide to Drugs Affecting Hemostasis

Abstract

The plastic surgeon is encountering an unprecedented population of aging individuals who both desire cosmetic or reconstructive surgery and may require the use of medications that alter hemostasis. The increasing use of anticoagulants and platelet inhibitors in particular can create challenges for the plastic surgeon. The purpose of this review is to familiarize the surgeon with the medications that can affect hemostasis and to suggest strategies for their use in the perioperative period. Specific case examples are presented.

Perioperative Management of Anticoagulant Therapy during Cutaneous Surgery: 2005 Survey of Mohs Surgeons

“…Many Mohs surgeons refer complicated repairs to their colleagues in other surgical fields, and it is important to be aware of the recommendations in other literature. Interestingly, a review article in the plastic surgery literature, published by Muskett and coworkers 25 in 2005, refers to the dermatologic surgery literature and concludes that for many minor or cutaneous procedures, anticoagulant and antiplatelet inhibitors do not need to be discontinued perioperatively. No current guidelines have been accepted by these surgical specialties, and this may pose a dilemma when referring between fields.…”

MOC-PSSM CME Article: Breast Reconstruction

“…9 Homeopathic medications such as garlic, ginseng, ginger, ginkgo biloba, St. John's wort, and echinacea should be discontinued 2 weeks before surgery because of the potential for increased bleeding. 10,11 …”

Guidelines for the Management of Antiplatelet Therapy in Patients With Coronary Stents Undergoing Non-Cardiac Surgery

“…Review of the published literature supports the continuation of antiplatelet agents in this setting [30,31]. Major reconstructive surgery usually follows extirpative oncological excisional surgery.…”