Lack of complications in skin surgery of patients receiving clopidogrel as compared with patients taking aspirin, warfarin, and controls.
Clopidogrel, a new antiplatelet agent that irreversibly inhibits platelet aggregation, is widely used today. This prospective work was conducted to evaluate the safety of performing skin surgery on patients taking clopidogrel. Patients undergoing surgery for excision of skin or subcutaneous lesions under local anesthesia taking clopidogrel were the study group. The control group comprised 2073 historical patients who had undergone a similar procedure. Data collected included: age, sex, past medical history, medications, and late complications. Follow-up was done at 1 to 2 weeks and 3 to 6 months. There were 32 patients on clopidogrel, having 38 lesions removed. Of these, seven patients were on aspirin and clopidogrel combined. The groups taking clopidogrel, aspirin, and warfarin had significantly more males, were older, and had significantly more comorbid medical conditions. There was no significant difference in the incidence of any of the complications in any of the groups. This study shows that patients taking clopidogrel before skin surgery, though older and with more associated medical conditions, do not experience a greater rate of complications. We conclude that patients undergoing minor excisional cutaneous surgery should continue taking clopidogrel because there is no apparent risk for increased complications when good meticulous surgical techniques are used.
Department of Plastic Reconstructive and Aesthetic Surgery, Assaf Harofeh Medical Center, Zerifin 70300, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
Eyal
E
Kramer
Eran
E
Hadad
Melvyn
M
Westreich
Avshalom
A
Shalom
D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects; D016022:Case-Control Studies; D000077144:Clopidogrel; D062109:Dermatologic Surgical Procedures; D004359:Drug Therapy, Combination; D064420:Drug-Related Side Effects and Adverse Reactions; D004890:Erythema / Q000139:chemically induced; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000139:chemically induced; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D011183:Postoperative Complications / Q000139:chemically induced*; D013529:Surgical Wound Dehiscence / Q000139:chemically induced; D013530:Surgical Wound Infection / Q000139:chemically induced; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D014859:Warfarin / Q000009:adverse effects
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin