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The Impact of Direct Oral Anticoagulant Prophylaxis for Thromboembolism in Thrombophilic Patients Undergoing Abdominoplastic Surgery

Congenital or acquired thrombophilia is observed in 10–15% of the general population; therefore, careful screening is carried out in patients at higher risk of venous thrombo-embolism (VTE). High risk of VTE is a contraindication in patients undergoing abdominoplasty. We evaluated rivaroxaban, an or...

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Autores principales: Verolino, Pasquale, Sagnelli, Caterina, Grella, Roberto, Nicoletti, Giovanni Francesco, Sica, Antonello, Faenza, Mario
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8949117/
https://www.ncbi.nlm.nih.gov/pubmed/35326953
http://dx.doi.org/10.3390/healthcare10030476
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author Verolino, Pasquale
Sagnelli, Caterina
Grella, Roberto
Nicoletti, Giovanni Francesco
Sica, Antonello
Faenza, Mario
author_facet Verolino, Pasquale
Sagnelli, Caterina
Grella, Roberto
Nicoletti, Giovanni Francesco
Sica, Antonello
Faenza, Mario
author_sort Verolino, Pasquale
collection PubMed
description Congenital or acquired thrombophilia is observed in 10–15% of the general population; therefore, careful screening is carried out in patients at higher risk of venous thrombo-embolism (VTE). High risk of VTE is a contraindication in patients undergoing abdominoplasty. We evaluated rivaroxaban, an oral Xa inhibitor, with enoxaparin, a subcutaneously low molecular weight heparin (LMWH), in 48 female patients with documented thrombophilia, undergoing thrombo-prophylaxis after abdominoplasty. Patients were stratified into two groups according to thrombo-prophylaxis procedure: enoxaparin Group (n = 28) and rivaroxaban Group (n = 20). Hematologic outcomes were evaluated including VTE and hematoma. No episodes of VTE occurred in both groups; two patients during their course of enoxaparin presented severe hematoma for drainage and hemostasis revision. This study suggests that abdominoplasty, in patients with thrombophilia, in combination with thrombo-prophylaxis can be performed safely. Rivaroxaban was as effective as LMWH for preventing VTE, with only a moderate risk of clinically relevant bleeding. More research is needed to determine the optimal timing and duration of prophylaxis in patients undergoing plastic surgery.
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spelling pubmed-89491172022-03-26 The Impact of Direct Oral Anticoagulant Prophylaxis for Thromboembolism in Thrombophilic Patients Undergoing Abdominoplastic Surgery Verolino, Pasquale Sagnelli, Caterina Grella, Roberto Nicoletti, Giovanni Francesco Sica, Antonello Faenza, Mario Healthcare (Basel) Article Congenital or acquired thrombophilia is observed in 10–15% of the general population; therefore, careful screening is carried out in patients at higher risk of venous thrombo-embolism (VTE). High risk of VTE is a contraindication in patients undergoing abdominoplasty. We evaluated rivaroxaban, an oral Xa inhibitor, with enoxaparin, a subcutaneously low molecular weight heparin (LMWH), in 48 female patients with documented thrombophilia, undergoing thrombo-prophylaxis after abdominoplasty. Patients were stratified into two groups according to thrombo-prophylaxis procedure: enoxaparin Group (n = 28) and rivaroxaban Group (n = 20). Hematologic outcomes were evaluated including VTE and hematoma. No episodes of VTE occurred in both groups; two patients during their course of enoxaparin presented severe hematoma for drainage and hemostasis revision. This study suggests that abdominoplasty, in patients with thrombophilia, in combination with thrombo-prophylaxis can be performed safely. Rivaroxaban was as effective as LMWH for preventing VTE, with only a moderate risk of clinically relevant bleeding. More research is needed to determine the optimal timing and duration of prophylaxis in patients undergoing plastic surgery. MDPI 2022-03-03 /pmc/articles/PMC8949117/ /pubmed/35326953 http://dx.doi.org/10.3390/healthcare10030476 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Verolino, Pasquale
Sagnelli, Caterina
Grella, Roberto
Nicoletti, Giovanni Francesco
Sica, Antonello
Faenza, Mario
The Impact of Direct Oral Anticoagulant Prophylaxis for Thromboembolism in Thrombophilic Patients Undergoing Abdominoplastic Surgery
title The Impact of Direct Oral Anticoagulant Prophylaxis for Thromboembolism in Thrombophilic Patients Undergoing Abdominoplastic Surgery
title_full The Impact of Direct Oral Anticoagulant Prophylaxis for Thromboembolism in Thrombophilic Patients Undergoing Abdominoplastic Surgery
title_fullStr The Impact of Direct Oral Anticoagulant Prophylaxis for Thromboembolism in Thrombophilic Patients Undergoing Abdominoplastic Surgery
title_full_unstemmed The Impact of Direct Oral Anticoagulant Prophylaxis for Thromboembolism in Thrombophilic Patients Undergoing Abdominoplastic Surgery
title_short The Impact of Direct Oral Anticoagulant Prophylaxis for Thromboembolism in Thrombophilic Patients Undergoing Abdominoplastic Surgery
title_sort impact of direct oral anticoagulant prophylaxis for thromboembolism in thrombophilic patients undergoing abdominoplastic surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8949117/
https://www.ncbi.nlm.nih.gov/pubmed/35326953
http://dx.doi.org/10.3390/healthcare10030476
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