Prevention of venous thromboembolism in body contouring surgery: a national survey of 596 ASPS surgeons.

Abstract

Venous thromboembolism (VTE) has been identified as a major public health issue. Postbariatric body contouring surgery represents a major challenge for VTE prophylaxis due to the presence of multiple risk factors and broad areas of dissection that potentially increase the risk of postoperative bleeding. To define current VTE prophylaxis practices among surgeons of the American Society of Plastic Surgeons, performing postbariatric body contouring surgery in the United States. A total of 4081 surveys were sent to registered members of the American Society of Plastic Surgeons by e-mail. We received 596 (14.6%) responses. A total of 596 surgeons returned completed surveys, with 83% of respondents in private practice and 17% in academic practice. Deep venous thrombosis (DVT) was reported by 40% surgeons, pulmonary embolism (PE) by 34%, and 7% had at least 1 patient having died of a postoperative PE. About 39% to 48% participant surgeons reported providing no chemoprophylaxis to their postbariatric body contouring patients. The most common reason for not using routine prophylaxis was the concern for bleeding (84%), followed by lack of evidence specific to plastic surgery practice (50%). Academic surgeons were more likely to provide chemoprophylaxis when compared with those in nonacademic practice (P < 0.05). For postbariatric body contouring surgery, DVT has occurred in over one-third of plastic surgeons' practices with 7% of surgeons reporting a patient death from PE. A substantial proportion of surgeons performing postbariatric body contouring are not using chemoprophylaxis due to bleeding risk and perceived lack of evidence. VTE prophylaxis in postbariatric body contouring remains a topic that deserves further study.