How safe is thromboprophylaxis in abdominoplasty?

• Published in: Plastic and reconstructive surgery (1963) Vol. 130; no. 6; p. 851e
• Main Authors: Dini, Gal Moreira, Ferreira, Maria Carolina Corsi, Albuquerque, Luciana Gianini, Ferreira, Lydia Masako
• Format: Journal Article
• Language: English
• Published: United States 01.12.2012
• Subjects: Abdominoplasty; Administration, Oral; Adult; Anticoagulants - adverse effects; Anticoagulants - therapeutic use; Double-Blind Method; Drug Administration Schedule; Early Termination of Clinical Trials; Female; Follow-Up Studies; Hematoma - chemically induced; Hematoma - epidemiology; Humans; Middle Aged; Morpholines - adverse effects; Morpholines - therapeutic use; Postoperative Care; Postoperative Complications - chemically induced; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; Postoperative Hemorrhage - chemically induced; Postoperative Hemorrhage - epidemiology; Prospective Studies; Pulmonary Embolism - etiology; Pulmonary Embolism - prevention & control; Rivaroxaban; Thiophenes - adverse effects; Thiophenes - therapeutic use; Treatment Outcome; Venous Thromboembolism - etiology; Venous Thromboembolism - prevention & control; Venous Thrombosis - etiology; Venous Thrombosis - prevention & control
• ISSN: 1529-4242
• DOI: 10.1097/PRS.0b013e31826d9fc0

Deep vein thrombosis and its most dangerous outcome, pulmonary embolism, are complications with a high incidence in hospitalized patients. In plastic surgery, abdominoplasty is the aesthetic surgery more frequently associated with deep vein thrombosis condition. This study aimed to test the efficacy and safety of oral rivaroxaban for the prevention of venous thromboembolism after abdominoplasty in patients considered to be at risk. In a randomized, double-blind study, 40 patients undergoing abdominoplasty were assigned to receive either oral rivaroxaban (10 mg) or oral placebo once daily for 10 days, beginning 6 to 8 hours after surgery. The study was interrupted after 27 operations due to systematic complications. The population operated on was composed of women with a mean age of 38 years. Most patients were Caucasian (85 percent) and had a mean body mass index of 28. The average overall rate of complications was 29.6 percent (large hematomas requiring drainage), and all complications were seen in the study group, with none in the control group. Plastic surgery procedures in which large detachment is planned in patients with a moderate risk of deep venous thrombosis should be evaluated with regard to the risk and benefit of thromboembolism prophylaxis. Other measures must be applied and eventually contraindicate a surgical procedure. Further research is needed to complement the data from this work.