Wednesday, November 5, 2008
14093

Recommendations for Patient Safety in Body Contouring Surgery After a Review of 4,000 Consecutive Cases

Christopher K. Patronella, MD, FACS, Amado Ruiz-Razura, MD, FACS, German Newall, MD, FACS, and Henry A. Mentz, MD, FACS.

In recent years, there has been an increasing demand among plastic surgeons for patient safety that specifically addresses the complications suffered by certain patients regarding deep venous thrombosis (DVT) and pulmonary embolism (PE). In a survey conducted by Broughton et al. [4], he reveals that less than 50% of plastic surgeons use thromboprophylaxis as part of their standard protocol when performing aesthetic surgery.  Pulmonary embolism represents the third highest cause of postoperative death in the US. Unfortunately, current data regarding this problem connected to aesthetic surgery is very limited. For this reason, it is our mission to share with fellow plastic surgeons our experiences taken from 17 patients, who have suffered from DVT/PE complications, in a review of 3,871 consecutive procedures performed over the last seven years in our center.

We conducted a retrospective chart review to identity the common factors responsible for causing DVT/PE among those high-risk patients who undergo aesthetic surgery.  Of these cases, we have calculated the following incidence rates: 0.46% for DVT, and 0.08% for PE.  We discovered that a culmination of factors working in a synergistic way plays a significant role in the development of DVT/PE. We conclude that a carefully planned out, comprehensive, appropriately enforced protocol is necessary to reduce the rate of thromboembolic events.  Practical safety measures and technical recommendations are presented that strongly encourages the use of thromboprophylaxis during the preoperative, intraoperative and postoperative phases of aesthetic surgical procedures.  Feel that DVT and PE should be an equal partnership between patient and surgeon.