Reish Richard G, Damjanovic Branimir, Colwell Amy S
Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Ann Plast Surg. 2012 Oct;69(4):412-4. doi: 10.1097/SAP.0b013e31824a45e0.
Body contouring has a higher rate of thromboembolism than traditional plastic surgery procedures. Although risk stratification protocols exist, few offer specific therapeutic guidelines for deep venous thrombosis prevention. This single surgeon series classifies 105 consecutive patients into low, moderate, high, and highest risk groups. The respective thromboembolism prevention treatment included pneumatic compression devices alone, postoperative low-dose unfractionated heparin (LDUH), preoperative and 2 doses of postoperative LDUH, and preoperative and postoperative LDUH/low-dose molecular weight heparin for 7 days. Complications included 1 reoperation for bleeding. There were no clinically detected deep venous thromboses. In conclusion, this treatment algorithm for thromboembolism prevention results in a low rate of bleeding and thrombosis. Further studies are warranted to determine optimal timing and duration of chemoprophylaxis in plastic surgery patients.
身体塑形手术的血栓栓塞发生率高于传统整形手术。尽管存在风险分层方案，但很少有针对深静脉血栓形成预防提供具体治疗指南的。本单术者系列研究将105例连续患者分为低、中、高和最高风险组。各自的血栓栓塞预防治疗包括单独使用气动压迫装置、术后低剂量普通肝素（LDUH）、术前及术后2剂LDUH，以及术前和术后使用LDUH/低剂量低分子量肝素7天。并发症包括1例因出血进行的再次手术。未检测到临床诊断的深静脉血栓形成。总之，这种血栓栓塞预防治疗方案导致出血和血栓形成发生率较低。有必要进一步研究以确定整形手术患者化学预防的最佳时机和持续时间。
