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Venous Thromboembolism Prophylaxis in Plastic Surgery.

Rohun Gupta¹, Chirag Bisht², Rafaella Genova³

¹Oakland University William Beaumont School of Medicine, Rochester, Michigan.

|January 17, 2024

Summary

This study found that chemoprophylaxis in cosmetic surgery patients did not significantly differ in venous thromboembolism (VTE) incidence without using a scoring system, suggesting the Caprini score may not be optimal for VTE prediction in aesthetic surgery.

Keywords:

Chemoprophylaxis Deep Venous Thrombosis Plastic Surgery

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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.