Venous thromboembolism in plastic surgery patients: survey results of plastic surgeons

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.