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Published on: November 21, 2013
Influence of preoperative blood pressure on postoperative bleeding complications following Mohs micrographic surgery
Riyad N H Seervai1, Sarah K Friske2, Emily Powell3
1Department of Dermatology, Oregon Health and Science University, Portland, Oregon, USA.
Background:
Hypertension is a common comorbidity in patients undergoing Mohs micrographic surgery (MMS). Evidence in other surgical fields has suggested that high blood pressure increases the risk of perioperative bleeding, predisposing patients to complications such as hematomas, dehiscence, wound infection, and necrosis.
Methods:
We reviewed medical charts of all 530 patients who underwent MMS at our institution in one calendar year to identify whether an association exists between preoperative blood pressure and bleeding outcomes in patients undergoing MMS.
Results:
Perioperative variables, including history of diagnosed hypertension, preoperative systolic blood pressure >160 mm Hg, systolic blood pressure >180 mm Hg, anticoagulation/antiplatelet therapy, tumor type, and number of stages did not significantly increase the risk of overall postoperative complications, including intra- and postoperative bleeding.
Conclusion:
Hypertensive patients and those on anticoagulation/antiplatelet therapy are not at significantly increased risk of bleeding or other complications following MMS.
Insights
High blood pressure and anticoagulation therapy do not significantly increase bleeding risks for patients undergoing Mohs micrographic surgery (MMS). This study found no increased complications for hypertensive patients during MMS procedures.
Area of Science:
- Dermatology
- Surgical Oncology
- Cardiology
Background:
- Hypertension is a frequent comorbidity in patients undergoing Mohs micrographic surgery (MMS).
- Previous research in other surgical fields indicates elevated blood pressure may heighten risks of perioperative bleeding and subsequent complications like hematomas and wound infections.
Purpose of the Study:
- To investigate the association between preoperative blood pressure and bleeding outcomes in patients undergoing MMS.
- To determine if hypertension poses a significant risk for complications after Mohs surgery.
Main Methods:
- A retrospective review of medical charts for 530 patients who underwent MMS within a one-year period.
- Analysis of perioperative variables including diagnosed hypertension, elevated systolic blood pressure thresholds (>160 mm Hg, >180 mm Hg), and anticoagulation/antiplatelet therapy.
Main Results:
- No significant increase in the risk of overall postoperative complications, including intraoperative and postoperative bleeding, was observed.
- Perioperative variables such as a history of hypertension, specific systolic blood pressure levels, and anticoagulation/antiplatelet use did not correlate with higher complication rates.
Conclusions:
- Patients with hypertension undergoing MMS are not at a significantly increased risk of bleeding or other complications.
- Anticoagulation or antiplatelet therapy in the context of MMS did not lead to a statistically significant increase in adverse bleeding outcomes.
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