The Impact of Chemoprophylaxis and Patients' Demographics on Bleeding After Abdominal Body Contouring Procedures.

IF 2 3区医学 Q2 SURGERY

Aesthetic Plastic Surgery Pub Date : 2025-06-02 DOI:10.1007/s00266-025-04975-w

Nicholas Fadell, Daehee Jeong, Sara Iskeirjeh, Mohammed Muneer, Rana Farsakoury, Zaki Alyazji, Ghanem Aljassem, Omar Braizat, Gary B Skolnick, Justin M Sacks, Graeme E Glass, Saif M Badran

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引用次数: 0

Abstract

Background: Despite the current increase in body contouring surgery (BCS), the impact of preoperative chemoprophylaxis on bleeding after BCS remains undetermined.

Methods: A single institution retrospective cohort study examined patients undergoing abdominal BCS (abdominoplasty, lower body lift, and/or liposuction). Outcomes included estimated blood loss (EBL), hemoglobin drop on the first post-operative day, drain output, length of hospital stay, and the need for surgical evacuation of hematoma or transfusion. Statistical tests performed included chi-square, Wilcoxon signed-rank, and linear regressions using R.

Results: Of the 697 patients, 136 (19.5%) received no anticoagulation, 324 (46.5%) had preoperative anticoagulation, 209 (29.9%) received both preoperative and postoperative anticoagulation, and 28 (4%) had missing data. Preoperative LMWH was linked to a 45% increase in serosanguinous drain output on day one (145 ml vs. 100 ml; p < 0.001) but did not increase bleeding risk. Male patients had higher odds of hematoma (OR 14.8, p < 0.001), greater need for blood (OR 5.13, p < 0.001) or plasma (OR 6.15, p < 0.001) transfusion, more significant hemoglobin drop (- 2.23 +/- 1.06 g/dL vs. - 1.43 +/- 1.01 g/dL, p < 0.001), and higher drain output on day one (180 mL vs. 130 mL, p < 0.001) and overall (655 mL vs. 380 mL, p < 0.001). Previous obesity surgery patients also had higher odds for hematoma (OR 3.24, p = 0.011), blood transfusion (OR 3.26, p = 0.002), and increased drain output.

Conclusions: Preoperative chemoprophylaxis in BCS is associated with increased serosanguinous drain output without additional bleeding risk. Male gender and a history of obesity surgery increase the risk of hematoma, hemoglobin drop, and transfusion needs.

Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .

查看原文本刊更多论文

化学预防和患者人口统计学对腹部形体轮廓手术后出血的影响。

背景：尽管目前身体轮廓手术（BCS）的增加，术前化学预防对BCS后出血的影响仍不确定。方法：一项单机构回顾性队列研究检查了接受腹部BCS（腹部成形术、下半身提升术和/或吸脂术）的患者。结果包括估计失血量（EBL）、术后第一天血红蛋白下降、排液量、住院时间、血肿手术清除或输血的需要。统计检验包括卡方、Wilcoxon符号秩和r线性回归。结果：697例患者中，136例（19.5%）未接受抗凝治疗，324例（46.5%）术前接受抗凝治疗，209例（29.9%）术前和术后均接受抗凝治疗，28例（4%）数据缺失。术前低分子肝素与第一天血清浆液排出量增加45%有关(145 ml vs 100 ml；结论：BCS术前化疗预防与血清浆液排出量增加相关，但无额外出血风险。男性和肥胖手术史增加血肿、血红蛋白下降和输血需求的风险。证据等级iii：本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者说明www.springer.com/00266。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Aesthetic Plastic Surgery 医学-外科

CiteScore

4.40

自引率

25.00%

发文量

479

审稿时长

3 months

期刊介绍： Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP). Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships. Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.