Venous Thromboembolism Prophylaxis in Plastic Surgery

Area of Science:

• Plastic Surgery
• Vascular Surgery
• Medical Informatics

Background:

• The American Society of Plastic Surgery (ASPS) recommended the Caprini score for venous thromboembolism (VTE) risk assessment in 2011, amended in 2013.
• Several studies have raised questions regarding the Caprini score's validity.
• This study evaluates chemoprophylaxis in cosmetic patients compared to ASPS guidelines.

Purpose of the Study:

• To assess the effectiveness of chemoprophylaxis in cosmetic surgery patients.
• To compare current VTE chemoprophylaxis recommendations with clinical experience.
• To evaluate the utility of the Caprini score in predicting VTE in aesthetic surgery patients.

Main Methods:

• Retrospective analysis of 1272 cosmetic surgery patients operated on by a single surgeon (2006-2016).
• Exclusion criteria included surgery length >6 hours, hypercoagulable states, or prior DVT/PE.
• Demographic data and VTE incidence were collected and analyzed.

Main Results:

• 71% of patients were categorized as high to highest VTE risk per Caprini score.
• The overall VTE rate was 0.08% (1 patient), which resolved with conservative therapy.
• No significant difference in VTE incidence was observed between patients who received chemoprophylaxis with or without a scoring system.

Conclusions:

• Chemoprophylaxis without a scoring system showed no significant difference in VTE incidence in this cosmetic surgery cohort.
• The Caprini Scoring system may not be optimal for predicting VTE in patients undergoing aesthetic surgery.
• Further research may be needed to refine VTE risk assessment in cosmetic surgery.