Thromboembolism in high-risk aesthetic surgery: experience with 17 patients in a review of 3871 consecutive cases.
BACKGROUND
Pulmonary embolism (PE) represents the third most frequent cause of postoperative death in the United States. In recent years, there has been an increasing demand among plastic surgeons for patient safety guidelines that specifically address the complications of deep venous thrombosis (DVT) and PE in relation to aesthetic surgery.


OBJECTIVE
In this study, we review 3871 consecutive major body contouring procedures performed over the last 8 years in our surgery center in an attempt to identify common factors that could have contributed to the onset of DVT/PE in 17 of these patients.


METHODS
We conducted a retrospective chart review to identify common factors associated with the occurrence of DVT/PE in high risk patients who undergo aesthetic surgery.


RESULTS
Among these patients, we calculated the following incidence rates: 0.46% for DVT and 0.08% for PE. We discovered that a culmination of factors working synergistically play a significant role in the development of DVT/PE.


CONCLUSIONS
We conclude that a carefully planned, comprehensive, appropriately enforced protocol is necessary to reduce the rate of thromboembolic events. Practical safety measures and technical recommendations are presented that strongly encourage the use of thromboprophylaxis during the pre-, intra-, and postoperative phases of aesthetic surgical procedures. We feel that DVT and PE prevention should involve a partnership between patient and surgeon.
Patronella
Christopher K
CK
ckpatronellamd@aol.com
Ruiz-Razura
Amado
A
Newall
Germán
G
Mentz
Henry A
HA
Arango
Monica L
ML
Assavapokee
Tiravat
T
Siarski
Jana L
JL
D000328:Adult; D000368:Aged; D006801:Humans; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000453:epidemiology* / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000453:epidemiology* / Q000209:etiology