Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Assessment tool predicts blood clot risk after plastic surgery

19.11.2010
Patients undergoing plastic/reconstructive surgeries benefit from individual blood clot risk assessments

Patients undergoing plastic or reconstructive surgery should receive a risk assessment before their procedure to predict whether they'll develop potentially fatal blood clots in the legs or lungs, according to research at the University of Michigan Medical School.

Researchers also found that 1 in 9 patients at highest risk based on that assessment will develop clots if not given clot-preventing medications after surgery.

Published in the November 2010 Journal of the American College of Surgeons, the study evaluated the Caprini Risk Assessment Model, a standard measurement tool used to assess the likelihood a patient will develop dangerous clots in the deep veins of the legs or lungs after surgery. While all patients admitted to U-M for surgery receive a Caprini risk assessment, it is not standard practice among plastic surgeons nationwide.

"Our data demonstrates that the Caprini Risk Assessment Model is a useful and effective tool for predicting how likely a patient is to develop venous thromboembolism (VTE) after plastic surgery," says Christopher J. Pannucci, M.D., M.S., resident in the U-M Section of Plastic and Reconstructive Surgery and the study's lead author.

Because past studies have shown that some plastic and reconstructive surgery patients are at high risk for developing clots and only about 50 percent of surgeons administer clot-preventing medications after surgery, Pannucci and fellow researchers sought to specifically validate whether the Caprini model was an effective tool for predicting risk and whether administering clot-preventing medications after surgery can reduce their risk.

"We found that the higher a patient's Caprini score, the more likely the patient is to develop blood clots after surgery. We also found that patients with the highest scores were at disproportionately greater risk for developing clots if no clot-preventing medications were administered within 60 days after surgery," Pannucci says.

For the study, researchers reviewed medical record data from 1,126 patients who had plastic or reconstructive surgery and who received no clot-preventing medicines after surgery.

Findings include:

The Caprini Risk Assessment tool is effective in predicting which plastic and reconstructive surgery patients will develop VTE. This study is the first time this theory was tested for plastic and reconstructive surgical patients.

A specific, high-risk group was identified. Patients with a Caprini score greater than 8 are at disproportionately higher risk for developing late VTE; 1 in 9 of these patients can expect to have an event if no clot-preventing medication is given within 60 days after the surgery.

"We used to think people developed blood clots while still on the operating table," Pannucci says. "But we showed that patients with lower risk scores tend to develop VTEs within two weeks after surgery, while patients with higher risk scores continue to be at risk 20, 40 and even 60 days after their operation."

The appropriate frequency and duration, and subsequent effectiveness of administering clot-preventing medications after surgery are currently being studied.

Risk Factors: The most common risk factors for developing blood clots after surgery are age, obesity, surgery duration, pregnancy or oral contraceptive use, cancer, personal or family history of clots, and when a person's blood clots easier than most due to genetically abnormal clotting factors.

Once an injury or surgery occurs, additional risk factors that increase clot risk include multi-system trauma, lower extremity fractures, immobility, multiple operations, need for indwelling central venous catheters, and various post-operative complications like systemic infection.

Effects of VTE: Patients who develop deep vein thrombosis (blood clots deep in the artieries of the legs) are at risk for developing pulmonary embolism. Pulmonary embolism occurs when a deep clot is pushed with the flow of blood toward the heart. This clot can subsequently pass through the heart and obstruct the pulmonary artery – main artery of the lungsresponsible for carrying oxygen-rich blood to the rest of the body - resulting in major heart and lung dysfunction and sometimes death.

Ten percent of patients who develop pulmonary embolism will die within one hour of the onset of symptoms. For patients who survive a PE event, 50 percent suffer strain to the right ventricle of the heart and 5 percent eventually develop chronic pulmonary hypertension.

Patients who develop DVT may suffer damage to the valves in the veins of their legs which can cause venous reflux and post-thrombotic syndrome, a condition where blood pools in the lower extremities causing chronic swelling, tenderness and painful ulcers.

Statistics: In 2008, members of the American Society for Plastic Surgeons performed 1.7 million cosmetic/plastic surgical procedures and 4.9 million reconstructive procedures.

VTE occurs with particularly high frequency after post-bariatric body contouring surgery, including circumferential abdominoplasty (7.7 percent), abdominoplasty (5 percent), and breast or upper body contouring (2.9 percent) and certain types of breast reconstruction (2.2 percent) procedures.

Additional authors: Steven Bailey, M.D., George Dreszer, M.D., Justin Zumsteg, M.D., Reda Jaber, B.S., Jenni Hamill, M.P.H., Keith Hume, M.A., Peter Rubin, M.D., Peter Neligan, M.D., Loree Kallianen, M.D., Ronald Hoxworth, M.D., Andrea Pusic, M.D., M.H.S., Edwin Wilkins, M.D., M.S.

Funding: This study was funded by the Plastic Surgery Educational Foundation.

Reference: Validation of the Caprini Risk Assessment Model in Plastic and Reconstructive Surgery Patients: Journal of the American College of Surgeons - 18 November 2010 (10.1016/j.jamcollsurg.2010.08.018)

http://www.journalacs.org/article/S1072-7515(10)01020-3/abstract

Jessica Soulliere | EurekAlert!
Further information:
http://www.umich.edu

More articles from Health and Medicine:

nachricht Millions through license revenues
27.04.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

nachricht New High-Performance Center Translational Medical Engineering
26.04.2017 | Fraunhofer ITEM

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Making lightweight construction suitable for series production

More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.

Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...

Im Focus: Wonder material? Novel nanotube structure strengthens thin films for flexible electronics

Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.

"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...

Im Focus: Deep inside Galaxy M87

The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.

Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...

Im Focus: A Quantum Low Pass for Photons

Physicists in Garching observe novel quantum effect that limits the number of emitted photons.

The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...

Im Focus: Microprocessors based on a layer of just three atoms

Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.

Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Fighting drug resistant tuberculosis – InfectoGnostics meets MYCO-NET² partners in Peru

28.04.2017 | Event News

Expert meeting “Health Business Connect” will connect international medical technology companies

20.04.2017 | Event News

Wenn der Computer das Gehirn austrickst

18.04.2017 | Event News

 
Latest News

Wireless power can drive tiny electronic devices in the GI tract

28.04.2017 | Medical Engineering

Ice cave in Transylvania yields window into region's past

28.04.2017 | Earth Sciences

Nose2Brain – Better Therapy for Multiple Sclerosis

28.04.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>