Spring Michelle A, Gutowski Karol A
Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Wisconsin, Madison, WI.
Aesthet Surg J. 2006 Sep-Oct;26(5):522-9. doi: 10.1016/j.asj.2006.07.003.
Recommendations for venous thromboembolism (VTE) prophylaxis have been published in the plastic surgery literature. However, no comprehensive survey of the overall incidence of VTE among plastic surgery patients has been undertaken.
This study was performed to determine the incidence of VTE in plastic surgery patients, to delineate which procedures have the most risk for VTE, and to establish whether published guidelines are utilized by plastic surgeons.
An e-mail survey was sent to 3797 plastic surgeons based in the United States. Of those queried, 1106 (29%) completed the questionnaire. Respondents were asked to report VTE events in their patients over the last 24 months. There were 8 patient-based questions about VTE prophylaxis to determine the preferred method used.
Overall, 329 VTE events were identified. The most commonly associated procedures were abdominoplasty with another procedure (87 events) and abdominoplasty alone (71 events). Whether abdominoplasty is performed alone or combined with another procedure, the survey revealed similar rates of VTE per 10,000 patients (36 events per 10,000 patients). Plastic surgeons' prophylaxis methods vary, and 38% of the respondents were not aware of the published recommendations.
Based on our study, abdominoplasty with or without a second procedure has the highest incidence of VTE events among plastic surgery procedures. Combining abdominoplasty with another procedure does not increase the risk for VTE. A significant number of plastic surgeons are not aware of the published recommendations, and there is no consistent VTE prophylaxis used by the plastic surgeons who responded to the survey.
整形外科文献中已发布了静脉血栓栓塞(VTE)预防的相关建议。然而,尚未对整形外科患者中VTE的总体发生率进行全面调查。
本研究旨在确定整形外科患者中VTE的发生率,明确哪些手术VTE风险最高,并确定整形外科医生是否采用了已发布的指南。
向美国的3797名整形外科医生发送了电子邮件调查问卷。在被询问的医生中,1106名(29%)完成了问卷。要求受访者报告过去24个月内其患者发生的VTE事件。有8个基于患者的关于VTE预防的问题,以确定所使用的首选方法。
总体而言,共识别出329例VTE事件。最常相关的手术是腹壁成形术联合另一手术(87例)和单纯腹壁成形术(71例)。无论腹壁成形术是单独进行还是与另一手术联合进行,调查显示每10000名患者的VTE发生率相似(每10000名患者36例)。整形外科医生的预防方法各不相同,38%的受访者不知道已发布的建议。
根据我们的研究,在整形外科手术中,无论是否进行二次手术,腹壁成形术的VTE事件发生率最高。腹壁成形术与另一手术联合进行不会增加VTE风险。相当数量的整形外科医生不知道已发布的建议,并且参与调查的整形外科医生在VTE预防方面没有一致的做法。