Reoperation for haematoma after breast reduction with preoperative administration of low-molecular-weight heparin: experience in 720 patients

J Plast Reconstr Aesthet Surg. 2012 Nov;65(11):1513-7. doi: 10.1016/j.bjps.2012.05.027. Epub 2012 Jun 23.

Abstract

Background: Venous thrombo-embolism (VTE) prophylaxis is of paramount importance in the management of surgical patients. Mechanical as well as pharmacologic modalities may be used. With the use of anticoagulative agents, there is a potential for increased operative and postoperative bleeding.

Aim: To assess the safety of perioperative use of low-molecular-weight heparin (LMWH) in the setting of breast reduction surgery.

Methods: Retrospective assessment of the reoperation rate due to haematoma formation for breast reductions performed under a regimen of preoperative and postoperative administration of LMWH during a 10-year period.

Results: A total of 720 patients (1358 breasts) received preoperative and postoperative treatment with LMWH. Reoperation due to haematoma formation was required for 37 breasts in 37 patients (5.1% of patients and 2.7% of breasts). Eight patients (1.1%) required transfusion. No patient or operative factors were associated with the need for reoperation. There were no documented cases of deep vein thrombosis or VTE.

Conclusion: The use of a pre- and postoperative LMWH prophylaxis regimen is associated with a reoperation rate for haematoma that is in the upper range reported in the literature.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anticoagulants / administration & dosage*
  • Chi-Square Distribution
  • Female
  • Hematoma / prevention & control
  • Hematoma / surgery*
  • Heparin, Low-Molecular-Weight / administration & dosage*
  • Humans
  • Mammaplasty*
  • Middle Aged
  • Postoperative Complications / prevention & control
  • Postoperative Complications / surgery*
  • Preoperative Period
  • Reoperation / statistics & numerical data*
  • Retrospective Studies
  • Risk Assessment
  • Thromboembolism / prevention & control

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight