[Is withdrawal of antiplatelet therapy necessary prior to skin cancer surgery?].
OBJECTIVE
The aim of this study was to assess the value of discontinuing antiplatelet treatment prior to surgery for skin cancer with loss of skin of up to 10 cm in diameter. The study hypothesis postulated equivalence between discontinuation of antiplatelet therapy and continuation of these drugs during the perioperative period with regard to risk of cutaneous complications.


METHODS
This was a prospective, randomised study comparing two groups of patients on long-term antiplatelet treatment scheduled for surgery for skin carcinoma. In the first group, patients underwent surgery without change to their antiplatelet therapy while in the second, antiplatelet treatment was discontinued and substituted with either flurbiprofen or isocoagulant fractionated heparin or calcium heparin. Sixty patients took part in the study. Statistical analysis using ANOVA and Mann-Whitney non-parametric tests was performed to compare the following variables: age, sex, number of pre- and post-operative consultations, complications (haemorrhage, haematoma, separation and infection) and quality of wound healing.


RESULTS
No statistically significant difference was seen between the two groups regarding either complications or quality of wound healing.


CONCLUSIONS
There appear to be no rational grounds for discontinuing antiplatelet therapy in advance of skin cancer surgery involving loss of skin of up to 10 cm in diameter.
Danino
A
A
Service de Chirurgie Plastique, CHU de Montréal, Université de Montréal, 1560 RTE-138, Montréal, Québec, Canada. daninoalain@yahoo.fr
Duvernay
A
A
Dautriche
R
R
Duvernay-Debin
R
R
Cottin
Y
Y
Dalac
S
S
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011300:Preoperative Care; D012878:Skin Neoplasms / Q000601:surgery*
D010975:Platelet Aggregation Inhibitors