THROMBOSIS PROPHYLAXIS IN HAIR TRANSPLANT SURGERY
DOI:
https://doi.org/10.63845/kwve6t87Palavras-chave:
transplante capilar, hair transplant, tromboembolismo pulmonar, embolia pulmonar, tromboprofilaxiaResumo
Objective. The aim of this report is to present a cohesive evidence-based approach to reducing venous thromboembolism (VTE) in hair transplant surgeries. VTE prevention includes deep venous thrombosis and pulmonary embolism. Despite international efforts in VTE prevention, guidelines do not exist for hair transplant surgeries worldwide. Data source. PubMed/MEDLINE. Review Methods. A comprehensive review of literature to VTE in hair transplant surgery was performed, identifying data on incidence of thrombotic complications and the outcomes of regimens for thrombo-prophylaxis. No data were available, then we compared other surgical specialties. Conclusions. We identified 17 articles, including 3 prospective cohort studies, 3 retrospective studies, 1 case-control study, and 10 systematic review studies. We did not identify any study related to hair transplant. Of the 17 articles selected, 7 are related to prophylaxis of DVT, 4 related to plastic surgeries, 4 related to otolaryngology-head and neck surgeries and 2 related to elective surgeries. The overall prevalence of VTE in otolaryngology appears lower than that of most other surgical specialties. The Caprini system allows effective individualized risk stratification for VTE prevention in otolaryngology. Mechanical and chemoprophylaxis (‘‘dual thromboprophylaxis’’) is recommended for patients with a Caprini score 7 or patients with a Caprini score of 5 or 6 who undergo to long surgeries, where an increase in surgical duration was directly associated with an increase in the risk for VTE, and when prolonged hospital stay is anticipated or mobility is limited. For patients with a Caprini score of 5 or 6, we recommend dual thromboprophylaxis or mechanical prophylaxis alone. Patients with a Caprini score 4 should receive mechanical prophylaxis alone. These finding may help inform preoperative and postoperative decision making related to surgery.
Referências
Cramer JD, Shuman AG, Brenner MJ. Antithrombotic Therapy for Venous Thromboembolism and Prevention of Thrombosis in Otolaryngology-Head and Neck Surgery: State of the Art Review. Otolaryngol Head Neck Surg. 2018;158(4):627-36. DOI: https://doi.org/10.1177/0194599818756599
Kim JY, Khavanin N, Rambachan A, McCarthy RJ, Mlodinow AS, De Oliveria GS, Jr., et al. Surgical duration and risk of venous thromboembolism. JAMA Surg. 2015;150(2):110-7. DOI: https://doi.org/10.1001/jamasurg.2014.1841
Caprini JA. Thrombosis risk assessment as a guide to quality patient care. Dis Mon. 2005;51(2-3):70-8. DOI: https://doi.org/10.1016/j.disamonth.2005.02.003
Blitzer RR, Eisenstein S. Venous Thromboembolism and Pulmonary Embolism: Strategies for Prevention and Management. Surg Clin North Am. 2021;101(5):925-38. DOI: https://doi.org/10.1016/j.suc.2021.06.015
Iverson RE, Gomez JL. Deep venous thrombosis: prevention and management. Clin Plast Surg. 2013;40(3):389-98. DOI: https://doi.org/10.1016/j.cps.2013.04.002
Cronin M, Dengler N, Krauss ES, Segal A, Wei N, Daly M, et al. Completion of the Updated Caprini Risk Assessment Model (2013 Version). Clin Appl Thromb Hemost. 2019;25:1076029619838052. DOI: https://doi.org/10.1177/1076029619838052
Caprini JA, Arcelus JI, Hasty JH, Tamhane AC, Fabrega F. Clinical assessment of venous thromboembolic risk in surgical patients. Semin Thromb Hemost. 1991;17 Suppl 3:304-12. DOI: https://doi.org/10.1055/s-2007-1002635
Pannucci CJ, Bailey SH, Dreszer G, Fisher Wachtman C, Zumsteg JW, Jaber RM, et al. Validation of the Caprini risk assessment model in plastic and reconstructive surgery patients. J Am Coll Surg. 2011;212(1):105-12. DOI: https://doi.org/10.1016/j.jamcollsurg.2010.08.018
Wilson S, Chen X, Cronin M, Dengler N, Enker P, Krauss ES, et al. Thrombosis prophylaxis in surgical patients using the Caprini Risk Score. Curr Probl Surg. 2022;59(11):101221. DOI: https://doi.org/10.1016/j.cpsurg.2022.101221
Kraft CT, Janis JE. Deep Venous Thrombosis Prophylaxis. Clin Plast Surg. 2020;47(3):409-14. DOI: https://doi.org/10.1016/j.cps.2020.03.002
Shuman AG, Hu HM, Pannucci CJ, Jackson CR, Bradford CR, Bahl V. Stratifying the risk of venous thromboembolism in otolaryngology. Otolaryngol Head Neck Surg. 2012;146(5):719-24. DOI: https://doi.org/10.1177/0194599811434383
Cuenca-Pardo J, Ramos-Gallardo G, Cárdenas-Camarena L, Contreras-Bulnes L, Lelevier De Alvear G. Searching for the Best Way to Assess the Risk of Thrombosis in Aesthetic Plastic Surgery; The Role of the Caprini/Pannucci Score. Aesthetic Plast Surg. 2019;43(5):1387-95. DOI: https://doi.org/10.1007/s00266-019-01428-z
Douketis JD, Spyropoulos AC, Anderson JM, Arnold DM, Bates SM, Blostein M, et al. The Perioperative Anticoagulant Use for Surgery Evaluation (PAUSE) Study for Patients on a Direct Oral Anticoagulant Who Need an Elective Surgery or Procedure: Design and Rationale. Thromb Haemost. 2017;117(12):2415-24. DOI: https://doi.org/10.1160/TH17-08-0553
Gold A. Deep vein thrombosis chemoprophylaxis in plastic surgery. Clin Plast Surg. 2013;40(3):399-404. DOI: https://doi.org/10.1016/j.cps.2013.04.003
Spring MA, Gutowski KA. Venous thromboembolism in plastic surgery patients: survey results of plastic surgeons. Aesthet Surg J. 2006;26(5):522-9. DOI: https://doi.org/10.1016/j.asj.2006.07.003
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2024 Arquivos Catarinenses de Medicina

Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.