Introduction:
According to a study published in the official medical journal of the American Society of Plastic Surgeons (ASPS), treatment with the anticoagulant (blood-thinning) drug Enoxaparin can lower the risk of serious blood clot-related complications called venous thromboembolism (VTE) for plastic surgery patients at high risk. In surgical patients, venous thromboembolism is a serious safety concern.
According to a new study, VTE rates in plastic surgery are higher than previously believed. According to studies, most plastic surgeons can identify patients more likely to have VTE. Still, they are only sometimes able to offer sufficient preventive treatments. VTE risk assessment and prevention was ranked as the highest patient security research priority by the plastic surgery foundation in response to this issue.
What Is Blood Thinner (Anti-clotting Medicine)?
Blood-thinning medications help the veins and arteries carry blood more efficiently. They prevent blood clots from growing or developing. They are used to treat some forms of heart disease, heart defects, and other problems that could make people more likely to develop dangerous clots.
These medications aid in preventing heart attacks and strokes. But there are risks involved as well: For instance, if individuals cut themselves, these medications will make them bleed more than usual. These medications often have more life-saving advantages than risks. However, one should educate themselves about both before starting to take them.
What Are the Types of Blood Thinners?
Three categories can be used to categorize the active components in anti-clotting drugs.
-
Oral anticoagulants prevent some coagulation factors from developing or functioning. Direct oral anticoagulants (DOACs) and vitamin K antagonists (coumarins) are included in this class of drugs. Anticoagulants taken orally are quite efficient. They are typically used to treat atrial fibrillation, following the implantation of mechanical heart valves, or following a pulmonary embolism.
-
Antiplatelets, such as ASA, prevent blood platelets from clotting as quickly. They are typically taken by persons who have suffered a heart attack or stroke and are weaker than anticoagulants.
-
Heparins also prevent some clotting factors from working. They effectively treat acute symptoms because they act quicker than other drugs.
How Do Blood Thinners Work?
The truth is that blood thinners do not thin the blood. They cannot disperse clots either. They do, however, prevent new clots from developing. They can also stop the expansion of current ones. Some blood thinners accomplish this by fighting with the liver's vitamin K. This is necessary for the body to produce the clotting factor proteins. These aid in bonding platelets, which are little fragments of blood cells.
Antiplatelets prevent platelets from adhering to one another and blood vessel walls, which causes clots to form. Anticoagulants are more potent than these medications. Instead of treating current blood clots, they are frequently administered to patients at risk of developing new ones.
What Is the Use of Blood Thinners in Plastic Surgery?
Given that the patient is frequently immobile during surgery and for several hours or days afterward, surgery is known to increase the risk of blood clot formation. Blood clot prevention is a crucial component of perioperative surgical treatment because it reduces the chance of blood clot development, a known risk factor for immobility.
Blood thinners are used to thin the blood in some patients, prolonging the time it takes to clot. Blood thinners are administered to other patients to stop the formation of new clots and the worsening of existing clots.
Some patients, such as those with a cardiac rhythm known as atrial fibrillation, will need blood thinners for prolonged periods. Others, including those recently undergoing surgery, may require a blood thinner while hospitalized but never again.
What Is the Role of Enoxaparin in Plastic Surgery Patients?
According to a study, Enoxaparin may aid in achieving one of plastic surgery's top safety priorities today: preventing major VTEs in high-risk patients. A potentially severe complication of venous thromboembolism is the development of blood clots that prevent blood flow to the lungs (pulmonary embolism) or legs (deep vein thrombosis). VTE carries a danger of instant death and a longer-term risk of complications and health issues.
About 3,334 patients receiving plastic and reconstructive surgery at four American hospitals were enrolled in the venous thromboembolism prevention study (VTEPS). All were regarded as having an elevated risk of VTE since they scored three or above on the Caprini risk assessment model, a standard VTE risk scale. The Caprini score was based on several well-known risk factors, including advanced age, certain cardiac or lung diseases, a recent history of VTE, and other health issues.
Enoxaparin, a form of blood-thinning medication licensed for individuals at risk of VTE, was administered to all patients included in the VTEPS. The incidence of VTE within 60 days after surgery was compared to similar people having plastic surgery at the same facilities without taking Enoxaparin as a preventative measure.
Enoxaparin lowers the rate of VTE in patients with the highest level of risk. Four percent of individuals receiving Enoxaparin experienced VTE when the Caprini risk score was over 8, as opposed to 8.5 percent of patients not getting the medication.
According to the VTEPS findings, Enoxaparin helps lower the rate of VTE among individuals undergoing plastic surgery who are at the highest risk. Current recommendations call for high-risk patients to have a whole week of postoperative anticoagulant therapy based on data from patients undergoing various types of surgery. More research will be required to determine the ideal Enoxaparin medication duration for individuals undergoing plastic surgery.
What Are the Adverse Effects of Blood Thinners?
The drugs are not intended to prevent blood from clotting fully. After all, severe blood loss would result from injuries if the blood failed to clot. However, using anti-clotting medication requires longer for the body to bind wounds and halt any bleeding.
The most frequent adverse reaction to oral anticoagulants and antiplatelet drugs is bleeding. Light nasal bleeds, gum bleeding, or skin bruises typically pose no threat. But more severe bleeding needs to be treated right away. If experiencing any of the following, one ought to see a doctor:
-
Heavy, continuous bleeding from the gums or nose.
-
Broad bruises.
-
Blood-red urine.
-
Dark crimson or black or blood in the stool.
-
Vomiting blood.
Conclusion:
Many plastic surgeons recommend routine anticoagulation (chemoprophylaxis) to patients undergoing plastic surgery to lower the risk of venous thromboembolism (VTE). Anticoagulation therapy is appealing because it makes sense on the surface. Its effectiveness and safety have been questioned, though.
