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2019, Number 1

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Cir Plast 2019; 29 (1)

Stratification of the risk of thrombosis and prophylaxis: What is the best score to stratify the risk of thrombosis in patients of plastic surgery? What is the best prophylaxis? Evidence Based Medicine

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

Language: Spanish
References: 73
Page: 35-66
PDF size: 373.51 Kb.


ABSTRACT

All patients who undergo surgery, including facial surgery, are at risk of becoming complicated with thrombosis. Thrombosis is the main fatal complication in patients who undergo tummy tucks; the incidence increases, when combined with liposuction or some other type of procedure. We present a systematic review with an MBE trend, to determine the best recommendation to rate the risk of thrombosis and the best prophylactic recommendations in plastic surgery patients. We took a scenario, a common case in plastic surgery, and analyzed the current classifications, rated the patient of the case presented, and compared the results and recommendations. There is a great discrepancy in the stratification of risk of thrombosis among the classifications used; the lowest grade was with the score of Caprini and the highest with IMPROVE and ACCP. There is a marked difference in risk classifications; however, there is an agreement in the recommendation of the use of low molecular weight heparin and in the general care. Current classifications do not include existing thrombogenic factors in plastic surgery patients. As long as there is no effective score adapted to plastic surgery patients, an existing classification should be used and the thrombogenic factors of the specialty procedures must be added, which will increase the scores of the patients and the indication of prophylaxis.


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