Department of Plastic Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Postbus 22660, 1100 DD Amsterdam, The Netherlands.
J Plast Reconstr Aesthet Surg. 2012 Nov;65(11):1513-7. doi: 10.1016/j.bjps.2012.05.027. Epub 2012 Jun 23.
Venous thrombo-embolism (VTE) prophylaxis is of paramount importance in the management of surgical patients. Mechanical as well as pharmacologic modalities may be used. With the use of anticoagulative agents, there is a potential for increased operative and postoperative bleeding.
To assess the safety of perioperative use of low-molecular-weight heparin (LMWH) in the setting of breast reduction surgery.
Retrospective assessment of the reoperation rate due to haematoma formation for breast reductions performed under a regimen of preoperative and postoperative administration of LMWH during a 10-year period.
A total of 720 patients (1358 breasts) received preoperative and postoperative treatment with LMWH. Reoperation due to haematoma formation was required for 37 breasts in 37 patients (5.1% of patients and 2.7% of breasts). Eight patients (1.1%) required transfusion. No patient or operative factors were associated with the need for reoperation. There were no documented cases of deep vein thrombosis or VTE.
The use of a pre- and postoperative LMWH prophylaxis regimen is associated with a reoperation rate for haematoma that is in the upper range reported in the literature.
静脉血栓栓塞症（VTE）的预防在外科患者的管理中至关重要。可以使用机械和药物两种方式。使用抗凝药物会增加手术和术后出血的风险。
评估在乳房缩小手术中围手术期使用低分子肝素（LMWH）的安全性。
回顾性评估在 10 年期间接受术前和术后 LMWH 治疗的乳房缩小手术患者中因血肿形成而再次手术的比率。
共有 720 例患者（1358 只乳房）接受了术前和术后 LMWH 治疗。37 例患者（5.1%的患者和 2.7%的乳房）因血肿形成需要再次手术。8 例患者（1.1%）需要输血。没有患者或手术因素与再次手术的需要相关。没有记录到深静脉血栓或 VTE 的病例。
使用术前和术后 LMWH 预防方案与文献报道的血肿再次手术率处于较高水平相关。
