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From Risk Assessment to Intervention: A Systematic Review of Thrombosis in Plastic Surgery

Thromboembolism is a feared complication in plastic surgery and is linked to higher rates of morbidity and mortality. Despite extensive research, there is a lack of consistency between recommendations and clinical protocols to be implemented pre and post-surgery to reduce the incidence of thromboemb...

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Autores principales: Patel, Heli S, Camacho, Justin M, Shifchik, Anastassia, Kalmanovich, Jacob, Burke, Emma, Harb, Salam, Patrus, Alan, Cheng, Daniel, Behnam, Amir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10405759/
https://www.ncbi.nlm.nih.gov/pubmed/37554601
http://dx.doi.org/10.7759/cureus.41557
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author Patel, Heli S
Camacho, Justin M
Shifchik, Anastassia
Kalmanovich, Jacob
Burke, Emma
Harb, Salam
Patrus, Alan
Cheng, Daniel
Behnam, Amir
author_facet Patel, Heli S
Camacho, Justin M
Shifchik, Anastassia
Kalmanovich, Jacob
Burke, Emma
Harb, Salam
Patrus, Alan
Cheng, Daniel
Behnam, Amir
author_sort Patel, Heli S
collection PubMed
description Thromboembolism is a feared complication in plastic surgery and is linked to higher rates of morbidity and mortality. Despite extensive research, there is a lack of consistency between recommendations and clinical protocols to be implemented pre and post-surgery to reduce the incidence of thromboembolism. A systematic literature review was conducted using Pubmed and Scopus databases to determine the risk factors, screening methods, and existing treatment models for thromboembolism prevention. Articles in non-English languages were excluded. Analysis indicated that predominant risk factors include age (>35), elevated body mass index, coagulation disorders, smoking, estrogen therapies, genetic predisposition, vascular endothelium damage, stasis, and use of general anesthesia in patients with a history of cancer. Implementation of a proper prophylactic protocol is dependent on understanding the interplay between the aforementioned risk factors and the utilization of well-defined, evidence-based guidelines, such as the 2005 Caprini Risk Assessment Model and ultrasound surveillance. The literature review revealed that mechanical prophylaxis is the primary prevention method, followed by thromboprophylaxis for patients with higher Caprini scores. Plastic surgeons often underestimate the present risk stratification tools available for the prophylactic intervention of thromboembolism due to the fear of bleeding or hematoma complications postoperatively. In summary, this literature review emphasizes the importance of plastic surgeons selecting protocols that is inclusive of the patient's risk profile to yield a reduced risk of thromboembolism.
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spelling pubmed-104057592023-08-08 From Risk Assessment to Intervention: A Systematic Review of Thrombosis in Plastic Surgery Patel, Heli S Camacho, Justin M Shifchik, Anastassia Kalmanovich, Jacob Burke, Emma Harb, Salam Patrus, Alan Cheng, Daniel Behnam, Amir Cureus Plastic Surgery Thromboembolism is a feared complication in plastic surgery and is linked to higher rates of morbidity and mortality. Despite extensive research, there is a lack of consistency between recommendations and clinical protocols to be implemented pre and post-surgery to reduce the incidence of thromboembolism. A systematic literature review was conducted using Pubmed and Scopus databases to determine the risk factors, screening methods, and existing treatment models for thromboembolism prevention. Articles in non-English languages were excluded. Analysis indicated that predominant risk factors include age (>35), elevated body mass index, coagulation disorders, smoking, estrogen therapies, genetic predisposition, vascular endothelium damage, stasis, and use of general anesthesia in patients with a history of cancer. Implementation of a proper prophylactic protocol is dependent on understanding the interplay between the aforementioned risk factors and the utilization of well-defined, evidence-based guidelines, such as the 2005 Caprini Risk Assessment Model and ultrasound surveillance. The literature review revealed that mechanical prophylaxis is the primary prevention method, followed by thromboprophylaxis for patients with higher Caprini scores. Plastic surgeons often underestimate the present risk stratification tools available for the prophylactic intervention of thromboembolism due to the fear of bleeding or hematoma complications postoperatively. In summary, this literature review emphasizes the importance of plastic surgeons selecting protocols that is inclusive of the patient's risk profile to yield a reduced risk of thromboembolism. Cureus 2023-07-08 /pmc/articles/PMC10405759/ /pubmed/37554601 http://dx.doi.org/10.7759/cureus.41557 Text en Copyright © 2023, Patel et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Plastic Surgery
Patel, Heli S
Camacho, Justin M
Shifchik, Anastassia
Kalmanovich, Jacob
Burke, Emma
Harb, Salam
Patrus, Alan
Cheng, Daniel
Behnam, Amir
From Risk Assessment to Intervention: A Systematic Review of Thrombosis in Plastic Surgery
title From Risk Assessment to Intervention: A Systematic Review of Thrombosis in Plastic Surgery
title_full From Risk Assessment to Intervention: A Systematic Review of Thrombosis in Plastic Surgery
title_fullStr From Risk Assessment to Intervention: A Systematic Review of Thrombosis in Plastic Surgery
title_full_unstemmed From Risk Assessment to Intervention: A Systematic Review of Thrombosis in Plastic Surgery
title_short From Risk Assessment to Intervention: A Systematic Review of Thrombosis in Plastic Surgery
title_sort from risk assessment to intervention: a systematic review of thrombosis in plastic surgery
topic Plastic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10405759/
https://www.ncbi.nlm.nih.gov/pubmed/37554601
http://dx.doi.org/10.7759/cureus.41557
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