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Benefits and Risks of Prophylaxis for Deep Venous Thrombosis and Pulmonary Embolus in Plastic Surgery

A Systematic Review and Meta-Analysis of Controlled Trials and Consensus Conference

Pannucci, Christopher J., M.D., M.S.; MacDonald, John K., M.A.; Ariyan, Stephan, M.D., M.B.A.; Gutowski, Karol A., M.D.; Kerrigan, Carolyn L., M.D., M.H.C.D.S.; Kim, John Y., M.D.; Chung, Kevin C., M.D., M.S.

Plastic and Reconstructive Surgery: February 2016 - Volume 137 - Issue 2 - p 709–730
doi: 10.1097/01.prs.0000475790.54231.28
Special Topics: Outcomes Article
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Summary: The goal of this consensus conference, sponsored by the American Association of Plastic Surgeons, was to perform a systematic review and meta-analysis of controlled trials to examine both the benefits and risks of venous thromboembolism prophylaxis in plastic surgery patients. The panel sought to assess the safety and effectiveness of recognized venous thromboembolism prophylaxis strategies, including variation in anesthetic management, use of elastic compression stockings or intermittent pneumatic compression, and use of chemoprophylaxis. The authors also sought to examine effectiveness and safety of prophylaxis in patients risk-stratified by procedure type or 2005 Caprini score. The panel met face to face in March of 2015 to perform an exhaustive review of the existing literature. The panel subsequently created consensus recommendations using the GRADE criteria. Important directions for future research were also identified.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

Salt Lake City, Utah; New Haven, Conn.; Chicago, Ill.; Lebanon, N.H.; Ann Arbor, Mich.; and London, Ontario, Canada

From the Division of Plastic Surgery, University of Utah; the Section of Plastic Surgery, Yale University; Plastic Surgery, University of Illinois; the Division of Plastic Surgery, Northwestern University; the Section of Plastic Surgery, Dartmouth-Hitchcock Medical Center; the Section of Plastic Surgery, University of Michigan; and the Department of Medicine, University of Western Ontario.

Received for publication May 21, 2015; accepted September 16, 2015.

Presented in part at the 94th Annual Meeting of the American Association of Plastic Surgeons, in Scottsdale, Arizona, April 11 through 14, 2015.

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Disclosure:None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this article. This study was funded by the American Association of Plastic Surgeons.

Christopher J. Pannucci, M.D., M.S., Division of Plastic Surgery, University of Utah, 30 North 1900 East, 3B400, Salt Lake City, Utah 84132, christopher.pannucci@hsc.utah.edu

©2016American Society of Plastic Surgeons