Alam Murad, Goldberg Leonard H
Division of Cutaneous and Aesthetic Surgery, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
Dermatol Surg. 2002 Nov;28(11):992-8; discussion 998. doi: 10.1046/j.1524-4725.2002.02085.x.
Antithrombotic medications may increase perioperative bleeding during cutaneous surgery. Whether to discontinue these medications before surgery is controversial.
To evaluate the available evidence in order to generate preliminary guidelines regarding the perioperative use of antithrombotics.
Presentation of two cases of adverse events after preoperative discontinuation of antithrombotics, review of current anticoagulant and antiplatelet drugs, and review of the literature concerning perioperative antithrombotics in cutaneous surgery.
Perioperative withholding of antithrombotics in cutaneous surgery may be associated with serious adverse vascular events. Continuing antithrombotics in these circumstances does not appear to significantly increase bleeding complications. The complexity of available antithrombotics makes case-by-case determinations regarding their use difficult.
Cutaneous surgeons should strongly consider perioperative continuation of patients' antithrombotic drugs. The final determination should be made by the surgeon after evaluation of the circumstances and, if necessary, consultation with other experts.
抗血栓药物可能会增加皮肤外科手术期间的围手术期出血。术前是否停用这些药物存在争议。
评估现有证据，以制定关于抗血栓药物围手术期使用的初步指南。
介绍两例术前停用抗血栓药物后发生不良事件的病例，回顾当前的抗凝和抗血小板药物，以及回顾有关皮肤外科手术中围手术期抗血栓药物的文献。
皮肤外科手术围手术期停用抗血栓药物可能与严重的不良血管事件相关。在这些情况下继续使用抗血栓药物似乎不会显著增加出血并发症。现有抗血栓药物的复杂性使得针对其使用进行逐案判定很困难。
皮肤外科医生应强烈考虑在围手术期继续使用患者的抗血栓药物。最终决定应由外科医生在评估具体情况后做出，必要时可咨询其他专家。
