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2019, Número 1

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Cir Plast 2019; 29 (1)


Estratificación del riesgo de trombosis y profilaxis: ¿cuál es la mejor puntuación para estratificar el riesgo de trombosis en los pacientes de cirugía plástica?, ¿cuál es la mejor profilaxis? Medicina basada en evidencia

Cuenca‑Pardo J, Ramos‑Gallardo G, Morales OM, Bucio‑Duarte J, Caravantes‑Cortés I

Idioma: Español
Referencias bibliográficas: 73
Paginas: 35-66
Archivo PDF: 380.44 Kb.


RESUMEN

Todos los pacientes que se someten a una cirugía, incluso cirugía facial, tienen el riesgo de que ésta se complique con una trombosis. La trombosis es la principal complicación mortal en aquéllos a los que se realiza abdominoplastia; la incidencia aumenta cuando se combina con liposucción u algún otro tipo de procedimiento. Presentamos una revisión sistemática con tendencia a la Medicina Basada en Evidencia (MBE) para determinar la mejor recomendación que califique el riesgo de trombosis y las mejores recomendaciones profilácticas en los pacientes de cirugía plástica. Tomamos como escenario un caso habitual en cirugía plástica: realizamos un análisis de las clasificaciones actuales, calificamos a la paciente del caso presentado y comparamos los resultados y recomendaciones. Existe gran discrepancia en la estratificación del riesgo de trombosis entre las clasificaciones utilizadas: la calificación más baja fue con la escala de Caprini y la más alta con las de IMPROVE y ACCP. Existe una diferencia notoria en las clasificaciones del riesgo; sin embargo, hay una concordancia en la recomendación del uso de heparina de bajo peso molecular y en los cuidados generales. Las clasificaciones actuales no incluyen factores trombogénicos existentes en los pacientes de cirugía plástica. Mientras no exista una escala efectiva y adaptada a los pacientes de cirugía plástica se deberá utilizar una clasificación existente y agregar los factores trombogénicos de los procedimientos de la especialidad, lo que aumentará la calificación de los pacientes y la indicación de la profilaxis.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Cabrera-Rayo A, Nellen-Hummel H. Epidemiología de la enfermedad tromboembólica venosa. Gac Med Mex 2007; 143 (Supl 1): 3-5.

  2. Zaragoza-Delgadillo JC, Sauri-Arce JCA, Ochoa-Carrillo FJ, Fuentes-del-Toro F. Prevención de la enfermedad tromboembólica venosa en cirugía. Gac Med Mex 2007; 143 (Supl 1): 35-39.

  3. Saad AN, Parina R, Chang D, Gosman AA. Risk of adverse outcomes when plastic surgery procedures are combined. Plast Reconstr Surg 2014; 134 (6): 1415-1422.

  4. Rao RB, Ely SF, Hoffman RS. Deaths related to liposuction. N Eng J Med 1999; 340 (19): 1471-1475.

  5. Ramírez-Guerrero JA. Liposucción. Consideraciones anestésicas y perioperatorias. Rev Mex Anest 2007; 30 (4): 233-241.

  6. Grazer FM, Jong RH. Fatal outcomes from liposuction. Census survey of cosmetic surgeons. Plast Reconstr Surg 2000; 105: 436-446.

  7. Feisher LA. Risk of anesthesia. In: Miller RD, Ed. Anesthesia. Churchill Livingstone; 2005. pp. 893-920.

  8. Katz BE, Bruck MC, Felsenfeld L et al. Power liposuction: report on complications. Dermatol Surg 2003; 29: 925-927.

  9. Hanke CW, Bullock S, Bernstein G. Current status of tumescent liposuction in the United States: national survey results. Dermatol Surg 1996; 22: 595-598.

  10. Hoefflin SM, Bornstein JB, Gordon M. General anesthesia in an office-based plastic surgical facility: a report on more than 23000 consecutive office-based procedures under general anesthesia with no significant anesthetic complications. Plats Reconstr Surg 2001; 107: 243-251.

  11. Scarborough DA, Herron JB, Khan A, Bisaccia E. Experience with more than 5,000 cases in which monitored anesthesia care was used for liposuction surgery. Aesth Plast Surg 2003; 27: 474-480.

  12. Hanke CW, Bernstein G, Bullock S. Safety of tumescent liposuction in 15,336 patients. National survey results. Dermatol Surg 1995; 21: 459-462.

  13. Johnson PJ. General anesthesia in an office-based plastic surgical facility: a report on more than 23,000 consecutive office-based procedures under general anesthesia with no significant anesthetic complications. Arch Facial Plast Surg 2001; 3: 287.

  14. Ibarra P, Arango J, Bayter J, Castro J, Cortes J et al. Consenso de la Sociedad Colombiana de Anestesiología y Reanimación, SCARE y de la Sociedad Colombiana de Cirugía Plástica, sobre las recomendaciones para el manejo de pacientes electivos de bajo riesgo. Rev Col Anest 2010; 37 (4): 390-403.

  15. Winocour J, Gupta V, Ramírez JR, Shack RB, Grotting JC, Higdon KK. Abdominoplasty: risk factor, complications rates, and safety of combined procedures. Plast Reconstr Surg 2015; 136: 597e-606e.

  16. Poore SO, Sillah N, Mahajan AY, Gotowski KA. Patient safety in the operating room: II intraoperative and postoperative. Plast Reconstr Surg 2012; 130: 1048-1058.

  17. Cárdenas-Salomón CM, Gutiérrez-Salgado JE, Márquez-Espriella C, Sánchez-Medal FP, Gallardo-Palacios GJ, Eljure-Eljure M. Tromboprofilaxis en Cirugía Plástica: ¿Cuándo, cómo y por qué? Cir Plast 2013; 23 (3): 168-178.

  18. Sánchez HA. Profilaxis de la enfermedad tromboembólica venosa. Cuad Cir 2000; 14: 44-54.

  19. Lenhart M, Homann HH, Daigeler A et al. Major and lethal complication of liposuction. Plast Reconstr Surg 2008; 121: 396e-403e.

  20. Pérez-García A, Briones-Pérez. Tromboprofilaxis en pacientes postquirúrgicos: revisión de 1,500 casos. Cir Cir 2004; 72: 287-291.

  21. Pannucci ChJ. Evidence-based Recipes for venous thromboembolism prophylaxis: a practical safety guide. Plast Reconstr Surg 2017; 139: 520e-532e.

  22. Caprini JA, Arcelus JI, Reyna JJ. Effective risk stratification of surgical and nonsurgical patients for venous thromboembolic disease. Semin Hematol 2001; 38: 12-19.

  23. 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): 105-112.

  24. Murphy RX Jr, Alderman A, Gutowski K, Kerrigan C, Rosolowski K, Schechter L et al. Evidence-based practices for thromboembolism prevention: summary of the ASPS Venous Thromboembolism Task Force Report. Plast Reconstr Surg 2012; 130 (1): 168e-175e.

  25. Cronin MA, Demgler N, Krauss ES, Segal A, Wei N, Daly M et al. Completion of the update Caprini risk assessment model (2013 version). Clin Appl Thromb Haemost 2019; 25: 1-10.

  26. Swanson E. The case against chemoprophylaxis for venous thromboembolism prevention and the rationale for SAFE anesthesia. Plast Reconstr Surg Glob Open 2014; 2: e160.

  27. Cuenca-Pardo J, Ramos-Gallardo G, Cárdenas-Camarena L, Contreras-Bulnes L, Lelevier-de Avelar G. Searching for the best way to assess the risk of thrombosis in aesthetic plastic surgery; the role of the Caprini/Pannucci score. Aesth Plast Surg 2019; 43 (5): 1387-1395.

  28. Turpie AG, Bauer KA, Caprini JA et al; Apollo Investigators. Fondaparinux combined with intermittent pneumatic compression vs. Intermittent pneumatic compression alone for prevention of venous thromboembolism after abdominal surgery: a randomized, double-blind comparison. J Thromb Haemost 2007; 5 (9): 1854-1861.

  29. Kim EK, Eom JS, Ahn SH et al. The efficacy of prophylactic low-molecular-weight heparin to prevent pulmonary thromboembolism in immediate breast reconstruction using the TRAM flap. Plast Reconstr Surg 2009; 123 (1): 9-12.

  30. Edwards JZ, Pulido PA, Ezzet KA et al. Portable compression device and low-molecular-weight heparin compared with low-molecular-weight heparin for thromboprophylaxis after total joint arthroplasty. J Arthroplasty 2008; 23 (8): 1122-1127. Epub 2008 Apr 2.

  31. Senaran H, Acaroglu E, Ozdemir HM et al. Enoxaparin and heparin comparison of deep vein thrombosis prophylaxis in total hip replacement patients. Arch Orthop Trauma Surg 2006; 126 (1): 1-5.

  32. Chin PL, Amin MS, Yang KY et al. Thromboembolic prophylaxis for total knee arthroplasty in Asian patients: a randomized controlled trial. J Orthop Surg (Hong Kong) 2009; 17 (1): 1-5.

  33. Colwell CW Jr, Kwong LM, Turpie AG et al. Flexibility in administration of fondaparinux for prevention of symptomatic venous thromboembolism in orthopedic surgery. J Arthroplasty 2006; 21 (1): 36-45.

  34. Barrellier MT, Level B, Parienti JJ et al. Short versus extended thromboprophylaxis after total knee arthroplasty: a randomized comparison. Thromb Res 2010; 126 (4): e298-e304.

  35. Bottaro FJ, Elizondo MC, Doti C, Bruetman JE et al. Efficacy of extended thromboprophylaxis in major abdominal surgery: what does the evidence show? A meta-analysis. J Thromb Haemost 2008; 99 (6): 1104-1111.

  36. Rasmussen MS, Jorgensen LN, Wille-Jørgensen P et al; FAME Investigators. Prolonged prophylaxis with dalteparin to prevent late thromboembolic complications in patients undergoing major abdominal surgery: a multicenter randomized open-label study. J Thromb Haemost 2006; 4 (11): 2384-2390.

  37. Rasmussen MS, Jørgensen LN, Wille-Jørgensen P. Prolonged thromboprophylaxis with low molecular weight heparin for abdominal or pelvic surgery. Cochrane Database Syst Rev 2009; 21 (1): CD004318.

  38. American College of Chest Physicians Antithrombotic Guidelines, 9th ed. Accessed November 13, 2013. Available at: http: //www.chestnet.org/Guidelines-and-Resources/Guidelines-and-Consensus- Statements/Antithrombotic-Guidelines-9th-Ed.

  39. Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133 (6 Suppl): 381S-453S.

  40. Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schuünemann HJ; American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel. Executive summary: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141 (2 Suppl): 7S-47S.

  41. Morales-Blanhir JE, Salas-Pacheco JL, Rosas-Romero MJ, Valle-Murillo MA. Diagnóstico de tromboembolia pulmonar. Arch Cardiol Mex 2011; 81 (2): 126-136.

  42. Davison SP, Venturi ML, Attinger Ch E, Baker SB, Spear SL. Prevention of venous thromboembolism in the plastic surgery patient. Plast Reconstr Surg 2004; 114 (3): 43e-51e.

  43. Guyatt G, Gutterman D, Baumann MH, Addrizzo-Harris D, Hylek EM, Phillips B et al. Grading strength of recommendations and quality of evidence in clinical guidelines: report from an American College of Chest Physicians Task Force. Chest 2006; 129 (1): 174-181.

  44. Anderson FA, Spencer FA. Risk factors for venous thrombolism. Circulation 2003; 107: 19-16.

  45. Henke P, Pannucci CH. VTE risk factor assessment and prophylaxis. Phlebology 2010; 25 (5): 219-223.

  46. Bumaschny E, Rafa CA, Reichman P. Evaluación preoperatoria del paciente quirúrgico. En: Galindo F, et al. Enciclopedia de cirugía digestiva. www.sacd.org.ar 2013; tomo I-101, pp. 1-20.

  47. Pastor-Torres LF, Antigao-Ramírez R, Honorato-Pérez JM, Junquera-Planas CM, Navarro-Salas E et al. Guías de práctica clínica de la Sociedad Española de Cardiología en la valoración del riesgo quirúrgico del paciente cardiópata sometido a cirugía no cardiaca. Rev Esp Cardiol 2001; 54: 186-193.

  48. www.outcomes-umassmed.org/IMPROVE/risk_score/index.html / www.DVT.ORG

  49. www.fundaciontorax.org/calc/embop/ScoreTVP.html

  50. Kakkos SK, Caprini JA, Geroulakos G, Nicolaides AN, Stansby GP, Reddy DJ. Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolism in high-risk patients. Cochrane Database Syst Rev 2008; (4): CD005258.

  51. Dini GM, Ferreira MC, Albuquerque LG et al. How safe is thromboprophylaxis in abdominoplasty? Plast Reconstr Surg 2012; 130: 851e-857e.

  52. Pannucci CJ, Dreszer G, Wachtman CF et al. Postoperative enoxaparin prevents symptomatic venous thromboembolism in high-risk plastic surgery patients. Plast Reconstr Surg 2011; 128: 1093-1103.

  53. Enoxaparin Side Effects. Accessed November 13, 2013. Available at: http: //www.drugs.com/sfx/enoxaparin-side-effects.html.

  54. Hatef DA, Kenkel JM, Nguyen MQ et al. Thromboembolic risk assessment and the efficacy of enoxaparin prophylaxis in excisional body contouring surgery. Plast Reconstr Surg 2008; 122: 269-279.

  55. Pannucci CJ, Wachtman CF, Dreszer G et al. The effect of post-operative enoxaparin on risk for re-operative hematoma. Plast Reconstr Surg 2012; 129: 160-168.

  56. Gómez-Outes A, Terleira-Fernández AI, Suárez-Gea ML, Vargas-Castrillón E. Dabigatran, rivaroxaban, or apixaban versus enoxaparin for thromboprophylaxis after total hip or knee replacement: Systematic review, meta-analysis, and indirect treatment comparisons. BMJ 2012; 344: e3675.

  57. Homans J. Thrombosis of the deep leg vein due to prolonged sitting. N Engl J Med 1954; 250: 148-149.

  58. Adabi K, Stern CS, Weichman KE, Garfein ES, Pothula A, Draper L et al. Population health implications of medical tourism. Plast Reconstr Surg 2017; 140 (1): 66-74.

  59. Franzblau LE, Chung KC. Impact of medical tourism on cosmetic surgery in the United States. Plast Reconstr Surg Glob Open 2013; 1 (7): e63.

  60. Ross KM, Moscoso AV, Bayer LR, Rosselli-Risal CL, Orgill DP. Plastic surgery complications from medical tourism treated in a U.S. Academic Medical Center. Plast Reconstr Surg 2018; 141 (4): 517-523.

  61. Ríos-Tejada F, Villegas-Fernández F, Azofra-García JA, Callol-Sánchez L. Síndrome del pasajero de clase económica. An Med Int (Madrid) 2002; 19 (11): 589-593.

  62. Ten Wolde M, Quak E, Prins MH, Kraaijenhagen RA, Buller HR. Long distance travelling increase risk of pulmonary embolism. Thromb Haemost 2001; 86 (Suppl).

  63. Cheung B, Duflou J. Pre-existing pulmonary thromboembolic disease in passengers with the «economy class syndrome». Aviat Space Environ Med 2001; 72: 747-749.

  64. Sanabria-Candla FA, Vaga-Cruz PJ. Tromboembolismo pulmonar: síndrome del viajero o síndrome de la clase turista. Rev Científica Médica 2005; 8 (1): 35-37.

  65. Suárez C. Síndrome de la clase turista. Med Clin (Barc) 2002; 119 (1): 16-17.

  66. Belcaro G, Geroulakos G, Nicolaides AN, Myers KA, Winfoed M. Venous thromboembolism from air travel: the LONFLIT study. Angiology 2001; 52: 369-374.

  67. Machin SJ, Mackie IJ, McDonald S, Bailey-King S, Colleridge-Smith P, Scurr JH. Airline travel: incidence and prevention of venous thrombosis. Thromb Haemost 2001; 87 (Suppl): 369-374.

  68. Swanson E. Prospective clinical study of 551 cases of liposuction and abdominoplasty performed individually and in combination. Plast Reconstr Surg Glob Open 2013; 1: e32.

  69. Reinish JF, Bresnick SD, Walker JW, Rosso RF. Deep venous thrombosis and pulmonary embolus after face lift: A study of incidence and prophylaxis. Plast Reconstr Surg 2001; 107: 1570.

  70. Stuzin JM, Baker TJ, Baker TM. Deep venous thrombosis and pulmonary embolus after face lift: a study of incidence and prophylaxis (discussion). Plast Reconstr Surg 2001; 107: 1576-1577.

  71. Durnig P, Jungwirth W. Low-molecular-weight heparin and postoperative bleeding in rhytidectomy. Plast Reconstr Surg 2006; 118: 502-507; discussion 508.

  72. Seruya M, Venturi ML, Iorio ML et al. Efficacy and safety of venous thromboembolism prophylaxis in highest risk plastic surgery patients. Plast Reconstr Surg 2008; 122: 1701-1708.

  73. Pannucci CJ, MacDonald JK, Ariyan S et al. 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. Plast Reconstr Surg 2016; 137: 709-730.




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