title: Safety and Efficacy of Novel Oral Anticoagulants vs Low Molecular Weight Heparin for Thromboprophylaxis in Large-Volume Liposuction and Body Contouring Procedures.
abstract: BACKGROUND
  Preventing venous thromboembolism (VTE) remains an important topic in the plastic surgery community. However, there is little consensus regarding appropriate VTE prophylaxis for patients undergoing common body contouring procedures.
  
  
  OBJECTIVE
  This study compared the use of two novel oral anticoagulants (Rivaroxaban and Apixiban) vs low molecular weight heparin (LMWH) for postoperative chemical prophylaxis in body contouring plastic surgery procedures.
  
  
  METHODS
  A single center retrospective chart review of 1572 patients who underwent body contouring plastic surgery procedures from January 2012 to February 2015 was performed. Major complications associated with chemical prophylaxis were reviewed including hematomas requiring surgical evacuation, acute blood loss anemia requiring transfusions, and thrombotic or hemorrhagic events.
  
  
  RESULTS
  Drug-related adverse events occurred in 1.27% (n = 20) of patients. The complications encountered by the 454 patients on LMWH consisted of 0.88% (n = 4) with hematomas requiring surgical evacuation, 0.44% (n = 2) with decreased hemoglobin requiring transfusions, and 0.22% (n = 1) with a deep vein thrombosis (DVT). The complications encountered by 703 patients on with Rivaroxaban consisted of 1.3% (n = 9) with hematomas requiring surgical evacuation, 0.43% (n = 3) with decreased hemoglobin requiring transfusions, and 0.1% (n = 1) with a DVT and pulmonary embolism. The complications encountered by 415 patients on with Apixaban consisted of 0.48% (n = 2) with a DVT.
  
  
  CONCLUSIONS
  Novel oral anticoagulants (Rivaroxaban and Apixiban) are comparable to LMWH for chemical prophylaxis after body contouring procedures with similar rates of drug-related complications. Further investigation is warranted with more clinical cases in order to recommend the use of this medication for routine postoperative chemical prophylaxis after body contouring procedures.
  
  
  METHODS
  3 Therapeutic.
authors.affiliation: Drs Morales, Patronella, Mentz, Newall, Hustak, and Fortes are plastic surgeons in private practice in Houston, TX. Mr Ruff is a medical student, Texas A&M Health Science Center, Temple, TX. Ms Bush is a medical student, The University of Texas Health Science Center, Houston, TX.
authors.forename: Rolando
authors.initials: R
authors.lastname: Morales
authors.affiliation: Drs Morales, Patronella, Mentz, Newall, Hustak, and Fortes are plastic surgeons in private practice in Houston, TX. Mr Ruff is a medical student, Texas A&M Health Science Center, Temple, TX. Ms Bush is a medical student, The University of Texas Health Science Center, Houston, TX.
authors.forename: Eric
authors.initials: E
authors.lastname: Ruff
authors.affiliation: Drs Morales, Patronella, Mentz, Newall, Hustak, and Fortes are plastic surgeons in private practice in Houston, TX. Mr Ruff is a medical student, Texas A&M Health Science Center, Temple, TX. Ms Bush is a medical student, The University of Texas Health Science Center, Houston, TX.
authors.forename: Christopher
authors.initials: C
authors.lastname: Patronella
authors.affiliation: Drs Morales, Patronella, Mentz, Newall, Hustak, and Fortes are plastic surgeons in private practice in Houston, TX. Mr Ruff is a medical student, Texas A&M Health Science Center, Temple, TX. Ms Bush is a medical student, The University of Texas Health Science Center, Houston, TX.
authors.forename: Henry
authors.initials: H
authors.lastname: Mentz
authors.affiliation: Drs Morales, Patronella, Mentz, Newall, Hustak, and Fortes are plastic surgeons in private practice in Houston, TX. Mr Ruff is a medical student, Texas A&M Health Science Center, Temple, TX. Ms Bush is a medical student, The University of Texas Health Science Center, Houston, TX.
authors.forename: Germán
authors.initials: G
authors.lastname: Newall
authors.affiliation: Drs Morales, Patronella, Mentz, Newall, Hustak, and Fortes are plastic surgeons in private practice in Houston, TX. Mr Ruff is a medical student, Texas A&M Health Science Center, Temple, TX. Ms Bush is a medical student, The University of Texas Health Science Center, Houston, TX.
authors.forename: Kristi L
authors.initials: KL
authors.lastname: Hustak
authors.affiliation: Drs Morales, Patronella, Mentz, Newall, Hustak, and Fortes are plastic surgeons in private practice in Houston, TX. Mr Ruff is a medical student, Texas A&M Health Science Center, Temple, TX. Ms Bush is a medical student, The University of Texas Health Science Center, Houston, TX.
authors.forename: Paul
authors.initials: P
authors.lastname: Fortes
authors.affiliation: Drs Morales, Patronella, Mentz, Newall, Hustak, and Fortes are plastic surgeons in private practice in Houston, TX. Mr Ruff is a medical student, Texas A&M Health Science Center, Temple, TX. Ms Bush is a medical student, The University of Texas Health Science Center, Houston, TX.
authors.forename: Amelia
authors.initials: A
authors.lastname: Bush
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion; D065427:Factor Xa Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006406:Hematoma / Q000139:chemically induced / Q000628:therapy; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D015187:Lipectomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000139:chemically induced / Q000628:therapy; D011720:Pyrazoles / Q000008:administration & dosage* / Q000009:adverse effects; D011728:Pyridones / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D000069552:Rivaroxaban / Q000008:administration & dosage* / Q000009:adverse effects; D013781:Texas; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D006495:Heparin, Low-Molecular-Weight; D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban; D000069552:Rivaroxaban