Hereditary coagulopathies: Practical diagnosis and management for the plastic surgeon

Tali Friedman, Devin Coon O'Brien, Joseph Michaels V, Franklin Bontempo, V. Leroy Young, Julio A. Clavijo, J. Peter Rubin

Research output: Contribution to journalArticle

Abstract

Background: Venous thromboembolism is a devastating complication representing one of the major causes of postoperative death in plastic surgery. Within the scope of plastic surgery, body-contouring procedures are often considered to carry a higher risk of venous thromboembolism. Hereditary thrombophilias comprise a group of conditions defined by a genetic predisposition to thrombosis development. Collectively, hereditary thrombophilias are present in at least 15 percent of Western populations and underlie approximately half of thromboembolic events. Although the topic of venous thromboembolism is discussed widely throughout the literature, there is little published on the diagnosis and management of hereditary thrombophilias in the plastic surgery literature. The goals of this study were to present a review of the major inherited thrombophilias, to delineate the risk of these disorders, and to recommend a practical algorithm for patient screening and management before major plastic surgery. Methods: A MEDLINE search was performed from 1965 to the present to review the literature on inherited thrombophilia disorders. Results: Based on the English language literature and clinical experience, the authors suggest practical guidelines for screening and management of hereditary thrombophilias. A thorough medical history and preoperative evaluation are key to reducing venous thromboembolism complications. Conclusions: Hereditary thrombophilias are present in a significant number of thromboembolic events. Preoperative vigilance on the part of the plastic surgeon may help to identify patients with undiagnosed hereditary thrombophilias and thereby decrease the incidence of venous thromboembolism.

Original languageEnglish (US)
Pages (from-to)1544-1552
Number of pages9
JournalPlastic and reconstructive surgery
Volume125
Issue number5
DOIs
StatePublished - May 1 2010
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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    Friedman, T., O'Brien, D. C., Michaels V, J., Bontempo, F., Young, V. L., Clavijo, J. A., & Rubin, J. P. (2010). Hereditary coagulopathies: Practical diagnosis and management for the plastic surgeon. Plastic and reconstructive surgery, 125(5), 1544-1552. https://doi.org/10.1097/PRS.0b013e3181d51344