Introduction: The appropriate DVT prophylaxis remains unclear in post-massive weight loss body contouring (BC) patients considering their rich subcutaneous vascularity. We report the efficacy of sequential compression devices (SCDs) and early ambulation in BC patients, with chemical prophylaxis added only for patients at high risk for DVT. Methods: Clinical outcomes were identified for all post-massive weight loss patients who underwent BC by one surgeon. Method of DVT prophylaxis used, and complications such as DVT/PE, post-operative bleeding, and re-operation were analyzed. Results: Two-hundred ninety-nine BC patients with 346 anesthetic events were analyzed. Pre-inductive SCDs were employed in 323 (93.35%) events. Intra-operative time averaged 4.52+/-3.22 hours. Eighteen patients (5.20%) at high risk for DVT were given chemical prophylaxis preoperatively. All patients had SCDs ordered postoperatively and were encouraged to ambulate within 24 hours. Hematomas occurred after 16 (4.62%) events. Seven (2.02%) patients required re-operation for bleeding, with 2 (11.1%) having received and 5 (1.52%) not having received chemical prophylaxis. No clinically significant DVT/PE occurred. Conclusions: SCDs and early ambulation appear effective against development of clinically significant DVT in BC patients with low to moderate risk for thrombosis. There is a tendency toward bleeding complications in this population, making chemical prophylaxis less desirable.
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