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Reyan Saghir, Noman Saghir, Renee Okhiria, Manu Sidhu, Terrell Okhiria, Marcos Sforza, SP7.1.2
DVT and Abdominoplasty: A Holistic 8-point protocol-based approach to prevent DVT, British Journal of Surgery, Volume 108, Issue Supplement_7, October 2021, znab361.139, https://doi.org/10.1093/bjs/znab361.139 - Share Icon Share
Abstract
Plastic surgery as a speciality is afflicted with one of the highest incidence rates of thromboembolic events, with abdominoplasty procedures known to assimilate the greatest rates of Deep Vein Thrombosis (DVT).
A total of 1078 abdominoplasty patients were enrolled onto an 8-point prophylaxis protocol with an inclusive holistic approach over a 7- year period. A 4-week smoking, HRT and COC cessation period was imposed on all patients and a maximum BMI score of 40 was required of all preoperative patients. Participants were administered with compression stockings, flowtrons and enoxaparin. Individuals with a DVT history were also required to be 1-year treatment free prior to surgery. Furthermore, the protocol necessitated post-operative deambulation of fit patients within 4 hours.
Between 2008 and 2013, no incidence of DVT was recorded in all 1078 abdominoplasty surgery patients, indicating the potential for this protocol to lead to a significantly lower incidence than any previously published methodology. Due to the zero-incidence rate of DVT, different hypotheses of DVT proportions were tested to find out the rates that could be statistically consistent with our sample, thereby providing conservative incidence rate estimates.
This 8-point DVT prophylaxis protocol is the first non-criteria based inclusive protocol aimed at preventing abdominoplasty-associated DVT. As a result, not a single incident of DVT was recorded over the seven-year period of this study. We therefore believe that a holistic and procedure-specific approach to prophylaxis can drastically reduce the occurrence of DVT in abdominoplasty surgery.
- deep vein thrombosis
- smoking
- enoxaparin
- body mass index procedure
- preoperative care
- surgical procedures, operative
- surgery specialty
- plastic surgery specialty
- plastic surgery procedures
- thromboembolic event
- thrombosis, deep venous, prophylaxis
- abdominoplasty
- stockings, compression
- prevention
- holistic approach