Intraoperative and postoperative bleeding problems in patients taking warfarin, aspirin, and nonsteroidal antiinflammatory agents. A prospective study.
BACKGROUND
Many patients who undergo cutaneous surgery take medications that can affect bleeding. The role of these medications in postoperative bleeding complications is unclear. Dermatologists have no clear guidelines regarding the need to discontinue these medications preoperatively.


OBJECTIVE
We designed a prospective study to evaluate the incidence of postoperative bleeding complications in patients taking aspirin, warfarin, or nonsteroidal antiinflammatory agents.


METHODS
Data were collected from patients undergoing Mohs surgery regarding preoperative medication history, operative bleeding, and postoperative bleeding. Frequency of postoperative bleeding complications was then evaluated.


RESULTS
There was no statistically significant difference in postoperative bleeding complications between patients on aspirin, warfarin, or nonsteroidal antiinflammatory agents, when compared with controls.


CONCLUSIONS
It may not be necessary to discontinue aspirin, warfarin, or nonsteroidal antiinflammatory agents in patients undergoing many common dermatologic surgical procedures, such as Mohs surgery.
Billingsley
E M
EM
Division of Dermatology, Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.
Maloney
M E
ME
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D001458:Bandages; D016063:Blood Loss, Surgical; D062109:Dermatologic Surgical Procedures; D005069:Evaluation Studies as Topic; D006406:Hematoma / Q000209:etiology; D006801:Humans; D015994:Incidence; D008487:Medical History Taking; D015580:Mohs Surgery; D019106:Postoperative Hemorrhage / Q000209:etiology*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D016038:Skin Transplantation; D013524:Surgical Flaps; D014859:Warfarin / Q000627:therapeutic use*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D014859:Warfarin; D001241:Aspirin