دورية أكاديمية
Venous Thromboembolism after DIEP Flap Breast Reconstruction: Review of Outcomes after a Postoperative Prophylaxis Protocol.
| العنوان: | Venous Thromboembolism after DIEP Flap Breast Reconstruction: Review of Outcomes after a Postoperative Prophylaxis Protocol. |
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| المؤلفون: | Tuaño KR; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado School of Medicine., Yang JH; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado School of Medicine., Fisher MH; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado School of Medicine., Le E; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado School of Medicine., Khatter NJ; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado School of Medicine., Kalia N; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado School of Medicine., Colakoglu S; Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital., Cohen JB; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado School of Medicine., Kaoutzanis C; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado School of Medicine., Chong TW; Division of Plastic and Reconstructive Surgery, Department of Surgery, Virginia Commonwealth University., Mathes DW; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado School of Medicine. |
| المصدر: | Plastic and reconstructive surgery [Plast Reconstr Surg] 2024 Jul 01; Vol. 154 (1), pp. 13e-20e. Date of Electronic Publication: 2023 Jul 25. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 1306050 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1529-4242 (Electronic) Linking ISSN: 00321052 NLM ISO Abbreviation: Plast Reconstr Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Original Publication: Baltimore : Williams & Wilkins, |
| مواضيع طبية MeSH: | Mammaplasty*/adverse effects , Mammaplasty*/methods , Venous Thromboembolism*/prevention & control , Venous Thromboembolism*/etiology , Venous Thromboembolism*/epidemiology , Perforator Flap*/adverse effects , Perforator Flap*/transplantation , Postoperative Complications*/prevention & control , Postoperative Complications*/etiology , Postoperative Complications*/epidemiology , Anticoagulants*/administration & dosage , Anticoagulants*/therapeutic use , Enoxaparin*/administration & dosage, Humans ; Female ; Retrospective Studies ; Middle Aged ; Adult ; Epigastric Arteries/transplantation ; Epigastric Arteries/surgery ; Clinical Protocols ; Incidence ; Risk Factors ; Breast Neoplasms/surgery ; Treatment Outcome |
| مستخلص: | Background: Deep inferior epigastric perforator (DIEP) flap breast reconstruction is among the higher-risk patient groups for venous thromboembolism (VTE) in plastic surgery. Surgeons often opt for a patient-specific approach to postoperative anticoagulation, and the field has yet to come to a consensus on VTE chemoprophylaxis regimens. Methods: A new chemoprophylaxis protocol was introduced starting in March of 2019 that involved 2 weeks of treatment with enoxaparin, regardless of patient risk factors. A retrospective chart review was conducted on all patients who underwent DIEP flap breast reconstruction at the authors' institution between January of 2014 and March of 2020. Patients were grouped based on whether they enrolled in the new VTE protocol in the postoperative period or not. Patient demographics, prophylaxis type, and outcomes data were recorded, retrospectively. The primary outcome measure was postoperative VTE incidence. Results: Risk of VTE was significantly higher in patients discharged without VTE prophylaxis compared with patients discharged with prophylaxis (3.7% versus 0%; P = 0.03). Notably, zero patients in the VTE prophylaxis group developed a deep venous thrombosis or pulmonary embolism. In addition, the risk of a VTE event was 25 times greater in patients with a Caprini score greater than or equal to 6 ( P = 0.0002). Conclusion: The authors demonstrate the successful implementation of a 2-week VTE chemoprophylaxis protocol in DIEP flap breast reconstruction patients that significantly reduces the rate of VTE while not affecting the rate of hematoma complications. Clinical Question/level of Evidence: Therapeutic, III. (Copyright © 2023 by the American Society of Plastic Surgeons.) |
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| المشرفين على المادة: | 0 (Anticoagulants) 0 (Enoxaparin) |
| تواريخ الأحداث: | Date Created: 20230728 Date Completed: 20240626 Latest Revision: 20240715 |
| رمز التحديث: | 20240715 |
| DOI: | 10.1097/PRS.0000000000010949 |
| PMID: | 37506353 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1529-4242 |
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| DOI: | 10.1097/PRS.0000000000010949 |