Skip Navigation LinksHome > August 2010 - Volume 67 - Issue 2 > Abdominal Craniectomy Implantation and Thromboembolism Proph...
Neurosurgery:
doi: 10.1227/01.NEU.0000371982.19935.21
Complication Avoidance

Abdominal Craniectomy Implantation and Thromboembolism Prophylaxis Resulting in Wound Hematoma

Fargen, Kyle M. MD, MPH; Bhasin, Rohit R. MD; Murad, Gregory J. MD

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Abstract

BACKGROUND: Refractory intracranial hypertension often is treated with craniectomy to prevent herniation and irreversible neurologic decline in those with salvageable brain injuries.

OBJECTIVE: We report 3 cases of iatrogenic abdominal hematoma at the site of craniectomy implantation secondary to abdominal subcutaneous deep vein thrombosis (DVT) prophylaxis.

METHODS: A retrospective chart review of patients with abdominal wound complications after craniectomy and abdominal bone flap implantation at the University of Florida from 2004 to 2008 was performed.

RESULTS: Three patients receiving subcutaneous DVT prophylaxis via abdominal injections developed hematomas at the site of abdominal implantation. The hematomas occurred 17 days, 20 days, and 6 weeks postoperatively. All required urgent hematoma evacuation. All had evidence of needle sticks overlying the implantation site.

CONCLUSION: To reduce the potential risk of wound hematoma, DVT prophylaxis injections should be performed remote to the surgical site in craniectomized patients with abdominal bone flap implantation.

Copyright © by the Congress of Neurological Surgeons

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