Journal article
Venous thromboembolism events after breast reconstructions with DIEP free flaps in 192 consecutive case.
- Modarressi A Département de chirurgie plastique, reconstructive et esthétique, hôpitaux universitaires de Genève, 4, rue Gabrielle-Perret-Gentil, 1205 Genève, Switzerland. Electronic address: ali.modarressi@hcuge.ch.
- Schettini AV Département de chirurgie plastique, reconstructive et esthétique, hôpitaux universitaires de Genève, 4, rue Gabrielle-Perret-Gentil, 1205 Genève, Switzerland.
- Rüegg EM Département de chirurgie plastique, reconstructive et esthétique, hôpitaux universitaires de Genève, 4, rue Gabrielle-Perret-Gentil, 1205 Genève, Switzerland.
- Pittet-Cuénod B Département de chirurgie plastique, reconstructive et esthétique, hôpitaux universitaires de Genève, 4, rue Gabrielle-Perret-Gentil, 1205 Genève, Switzerland.
- 2017-12-10
Published in:
- Annales de chirurgie plastique et esthetique. - 2018
Breast reconstruction
DIEP
Evénements thromboembolique veineux
Reconstruction mammaire
Venous thromboembolism
Adult
Anticoagulants
Body Mass Index
Epigastric Arteries
Female
Free Tissue Flaps
Humans
Incidence
Length of Stay
Mammaplasty
Middle Aged
Perforator Flap
Pulmonary Embolism
Retrospective Studies
Risk Assessment
Risk Factors
Smoking
Switzerland
Time Factors
Venous Thromboembolism
English
BACKGROUND
Patient candidates for breast reconstruction with free deep inferior epigastric perforator flap (DIEP) may present several risk factors for venous thromboembolism (VTE). Risk identification is essential for appropriate VTE prophylaxis measures to be put in place. This study aims to investigate VTE incidence after DIEP flap breast reconstruction and to assess the accuracy of the Caprini Risk Assessment Model (RAM), which is the unique score validated to assess the VTE risk for plastic surgery procedures and identify patients at high VTE risk.
METHODS
A chart review was conducted of 192 consecutive patients who underwent breast reconstruction with a DIEP flap from 1999 to 2016. VTE rate was assessed and the Caprini score was calculated for each patient and correlated with the VTE incidence.
RESULTS
During the 90 post-operative days, four patients presented a pulmonary embolism (2.1%) and two patients (1%) had deep venous thrombosis (overall VTE incidence of 3.1%). Most patients (92.2%) were assessed as high-risk (Caprini score >5) and all VTE occurred among this group. Apart from the Caprini score, no specific single risk factor could be identified for VTE.
CONCLUSIONS
Our data confirm that the Caprini RAM is a valuable assessment tool for VTE risk measurement among all patients undergoing autologous breast reconstruction. As most candidates for DIEP flap belong to the high-risk group, combined anticoagulation prophylaxis methods are required for most cases, particularly chemoprophylaxis up to four weeks postoperatively.
Patient candidates for breast reconstruction with free deep inferior epigastric perforator flap (DIEP) may present several risk factors for venous thromboembolism (VTE). Risk identification is essential for appropriate VTE prophylaxis measures to be put in place. This study aims to investigate VTE incidence after DIEP flap breast reconstruction and to assess the accuracy of the Caprini Risk Assessment Model (RAM), which is the unique score validated to assess the VTE risk for plastic surgery procedures and identify patients at high VTE risk.
METHODS
A chart review was conducted of 192 consecutive patients who underwent breast reconstruction with a DIEP flap from 1999 to 2016. VTE rate was assessed and the Caprini score was calculated for each patient and correlated with the VTE incidence.
RESULTS
During the 90 post-operative days, four patients presented a pulmonary embolism (2.1%) and two patients (1%) had deep venous thrombosis (overall VTE incidence of 3.1%). Most patients (92.2%) were assessed as high-risk (Caprini score >5) and all VTE occurred among this group. Apart from the Caprini score, no specific single risk factor could be identified for VTE.
CONCLUSIONS
Our data confirm that the Caprini RAM is a valuable assessment tool for VTE risk measurement among all patients undergoing autologous breast reconstruction. As most candidates for DIEP flap belong to the high-risk group, combined anticoagulation prophylaxis methods are required for most cases, particularly chemoprophylaxis up to four weeks postoperatively.
- Language
-
- English
- Open access status
- hybrid
- Identifiers
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- DOI 10.1016/j.anplas.2017.11.001
- PMID 29221853
- Persistent URL
- https://folia.unifr.ch/global/documents/34064
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