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Anticoagulant Complications in Facial Plastic and Reconstructive Surgery
- Source :
- JAMA Facial Plastic Surgery. 17:103-107
- Publication Year :
- 2015
- Publisher :
- Mary Ann Liebert Inc, 2015.
-
Abstract
- The decision whether to discontinue antiplatelet and/or anticoagulant medications before a facial plastic surgical procedure is a complicated and multifactorial process that involves weighing the risk of perioperative thromboembolic complications with bleeding-related complications.To determine the complication rates in patients who undergo a range of facial plastic surgical procedures while receiving antiplatelet and/or anticoagulation therapy.A total of 9204 surgical procedures from January 1, 2007, through December 31, 2012, at an academic medical center and its affiliated surgical sites were analyzed, with patients who continued receiving antiplatelet and/or anticoagulation (aspirin, clopidogrel bisulphate, and warfarin sodium) therapy during the perioperative period identified and compared with a matched case-control group of patients who did not receive antiplatelet and/or anticoagulation therapy during this period.Facial plastic surgery procedures and perioperative management.Complication rates of wound healing (dehiscence or necrosis), infection, bleeding (hematoma or ecchymosis), and return to the operating room.Patients who received aspirin therapy at the time of surgery were not more likely to have a complication compared with control patients (odds ratio [95% CI], 0.73 [0.45-1.17]). Patients who received warfarin had increased perioperative bleeding (odds ratio [95% CI], 3.80 [1.15-12.60]) and postoperative infections (odds ratio [95% CI], 7.29 [1.17-45.40]) compared with control patients. Serious complications (flap necrosis, dehiscence, or return to the operating room) were not increased with warfarin use.This study demonstrates that patients who undergo facial plastic surgery may continue taking antiplatelet and/or anticoagulation therapy during the perioperative period safely with minimal serious complications.3.
- Subjects :
- Male
Reoperation
Reconstructive surgery
medicine.medical_specialty
Ticlopidine
medicine.drug_class
Hemorrhage
Preoperative care
Necrosis
Postoperative Complications
Hematoma
Surgical Wound Dehiscence
medicine
Humans
Surgical Wound Infection
Surgical Flaps
Aged
Aspirin
business.industry
Anticoagulant
Warfarin
Anticoagulants
Perioperative
Middle Aged
medicine.disease
Intraoperative Hemorrhage
Clopidogrel
Surgery
Treatment Outcome
Case-Control Studies
Female
business
Platelet Aggregation Inhibitors
medicine.drug
Subjects
Details
- ISSN :
- 21686092 and 21686076
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- JAMA Facial Plastic Surgery
- Accession number :
- edsair.doi.dedup.....fcc3da95d8a8a88568f1718841111c6f