The Impact of Direct Oral Anticoagulant Prophylaxis for Thromboembolism in Thrombophilic Patients Undergoing Abdominoplastic Surgery

Healthcare

Caterina Sagnelli¹  Antonello Sica²  Pasquale Verolino³  Giovanni Francesco Nicoletti³  Mario Faenza³  Roberto Grella³ 

[1] Department of Mental Health and Public Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;Multidisciplinary Department of Medical Surgical and Dental Specialties, Unit of Plastic Surgery, University of Campania “Luigi Vanvitelli”, 80120 Naples, Italy;

关键词: abdominoplasty;    thrombophilia;    thromboprophylaxis;    venous;    thromboembolism;    hematoma;   

DOI  :  10.3390/healthcare10030476

来源: DOAJ

【 摘 要 】

Congenital or acquired thrombophilia is observed in 10–15% of the general population; therefore, careful screening is carried out in patients at higher risk of venous thrombo-embolism (VTE). High risk of VTE is a contraindication in patients undergoing abdominoplasty. We evaluated rivaroxaban, an oral Xa inhibitor, with enoxaparin, a subcutaneously low molecular weight heparin (LMWH), in 48 female patients with documented thrombophilia, undergoing thrombo-prophylaxis after abdominoplasty. Patients were stratified into two groups according to thrombo-prophylaxis procedure: enoxaparin Group (n = 28) and rivaroxaban Group (n = 20). Hematologic outcomes were evaluated including VTE and hematoma. No episodes of VTE occurred in both groups; two patients during their course of enoxaparin presented severe hematoma for drainage and hemostasis revision. This study suggests that abdominoplasty, in patients with thrombophilia, in combination with thrombo-prophylaxis can be performed safely. Rivaroxaban was as effective as LMWH for preventing VTE, with only a moderate risk of clinically relevant bleeding. More research is needed to determine the optimal timing and duration of prophylaxis in patients undergoing plastic surgery.

【 授权许可】

Unknown