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关于近期心肌梗死后患者适时进行皮肤科手术的专家意见。

Expert Opinion Regarding Appropriately Timing Dermatological Surgeries in Patients With Recent Myocardial Infarctions.

机构信息

Department of Dermatology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

出版信息

Dermatol Surg. 2020 Dec;46(12):1560-1563. doi: 10.1097/DSS.0000000000002462.

Abstract

BACKGROUND

There is limited data on the risk of perioperative myocardial infarctions (MIs) in patients with a recent MI who undergo dermatologic surgeries.

OBJECTIVE

Present the recommendations of dermatologic surgeons and cardiologists to determine the safety of dermatologic surgeries after a recent MI.

METHODS

An electronic survey was distributed to Mohs surgeons and cardiologists to infer the risk of major adverse cardiac events (MACE) inherent to dermatologic surgery and determine timing of dermatologic surgery in patients with a recent MI.

RESULTS

One hundred twenty Mohs surgeons and 30 cardiologists were surveyed. Ninety-seven percent of cardiologists and 87% of Mohs surgeons deemed cutaneous excisions and Mohs micrographic surgery as low-risk procedures with less than one-percent chance of MACE. Seventy-seven percent of cardiologists and 46% of Mohs surgeons stated dermatologic surgery should either not be delayed or be delayed up to 1 month after an MI. Responses between cardiologists and Mohs surgeons did not significantly differ.

CONCLUSION

A preponderance of surveyed experts believe that most dermatologic surgeries may be safely performed in patients with a history of an MI within 1 month. The decision to implement urgent dermatologic surgery in patients with a recent MI should account for all clinically significant factors.

摘要

背景

近期心肌梗死 (MI) 患者行皮肤科手术围手术期心肌梗死 (MI) 的风险数据有限。

目的

提出皮肤科医生和心脏病专家的建议,以确定近期 MI 后行皮肤科手术的安全性。

方法

对 Mohs 外科医生和心脏病专家进行了电子调查,以推断近期 MI 患者行皮肤科手术的主要不良心脏事件 (MACE) 风险,并确定皮肤科手术的时机。

结果

调查了 120 名 Mohs 外科医生和 30 名心脏病专家。97%的心脏病专家和 87%的 Mohs 外科医生认为皮肤切除术和 Mohs 显微手术是低风险手术,MACE 的几率小于 1%。77%的心脏病专家和 46%的 Mohs 外科医生表示,皮肤科手术不应延迟或应在 MI 后 1 个月内延迟。心脏病专家和 Mohs 外科医生的回答没有显著差异。

结论

大多数调查专家认为,近期有 MI 病史的患者在 1 个月内可安全进行大多数皮肤科手术。在近期 MI 患者中实施紧急皮肤科手术的决定应考虑所有具有临床意义的因素。

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