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Enoxaparin-induced skin necrosis at injection site after total knee arthroplasty

Max Haffner1, Nasser Heyrani1, John P Meehan1

  • 1Department of Orthopaedics, University of California, Sacramento, CA, USA.

Arthroplasty Today
|March 22, 2018
PubMed

Enoxaparin is a widely used low-molecular-weight heparin for perioperative thromboembolic prophylaxis. Enoxaparin-induced skin necrosis in the setting of arthroplasty has been rarely reported in the literature with varying outcomes and management decisions. Our patient developed skin necrosis at his injection site and thrombocytopenia 10 days following left total knee arthroplasty surgery and after receiving subcutaneous Lovenox injections postoperatively. The patient was started on an alternative anticoagulation based on a high suspicion for heparin-induced thrombocytopenia and the wound was monitored without surgical debridement. Our case highlights the key clinical management decisions when facing this potentially life-threatening adverse reaction.

Keywords:
Adverse reactionArthroplastyEnoxaparinLovenoxSkin necrosis

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