A systematic review of mechanical thromboprophylaxis in the lithotomy position

Gelder, C.L.; McCallum, Audrey L.; Macfarlane, Alan; Anderson, John H.

doi:10.1016/j.surge.2018.03.005

Cited by 10 publications

(8 citation statements)

References 25 publications

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“…A systematic review of mechanical thromboprophylaxis and lithotomy position 82 identified the lack of conclusive evidence to show that mechanical thromboprophylaxis causes compartment syndrome in the lithotomy position. The authors acknowledge that evidence is limited.…”

Section: Contraindications and Complications Of Thromboprophylactic M...mentioning

confidence: 99%

Thromboprophylaxis in gynaecology: a review of current evidence

Nambiar

Thachil

Yoong

et al. 2023

The Obstetric & Gynaecologis

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Thromboembolism is a major cause of preventable morbidity and mortality. Hospital acquired thrombosis (HAT) accounts for 50-60% of all thromboembolic events. As well as effects on patient safety, there are considerable cost implications to both prophylaxis and treatment. While guidance exists on thromboprophylaxis for patients in obstetrics and those undergoing general surgery, there is a paucity of guidance relating to gynaecological practice. Increasing prevalence of risk factors and multimorbidity is paralleled by higher risk of thromboembolic events. Gynaecological surgery presents some unique risk factors for thrombosis. Learning objectivesTo understand the basic pathophysiology of thrombosis in relation to risk factors particularly relevant to gynaecology and pelvic surgery.To know the current evidence in key areas relevant to gynaecological practice: early pregnancy; day case surgery; minimally invasive gynaecological surgery; open and complex benign gynaecology and gynaecological oncology. To be aware of proposed guidance on risk assessment and prophylaxis in thrombosis as relevant to the gynaecologist based on current evidence. Ethical issuesProblems with thromboprophylaxis in high-risk patients include noncompliance and refusing animal products/injections. Clinicians may be reluctant to institute thromboprophylaxis, most times because of the possible risks of bleeding.

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Section: Contraindications and Complications Of Thromboprophylactic M...mentioning

confidence: 99%

Thromboprophylaxis in gynaecology: a review of current evidence

Nambiar

Thachil

Yoong

et al. 2023

The Obstetric & Gynaecologis

View full text Add to dashboard Cite

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“…Risk factors for deep venous thrombosis and pulmonary embolism include age older than 35, BMI more than 25, hypercoagulability, family history, smoking, and estrogen therapy. 82 To lower those risks, patients can lose weight and temporarily cease taking exogenous estrogen 3–4 weeks before and after surgery. Sequential compression devices can be used during surgery and the stirrups positioned so the hips flex at 90 degrees in the lithotomy position, maximizing venous drainage.…”

Section: Anesthesiamentioning

confidence: 99%

The Safe Practice of Female Genital Plastic Surgery

Furnas

Canales²,

Pedreira

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Summary: The purpose of this article is to guide surgeons in the safe practice of female genital plastic surgery when the number of such cases is steadily increasing. A careful review of salient things to look for in the patient’s motivation, medical history, and physical examination can help the surgeon wisely choose best candidates. The anatomy is described, with particular attention given to the variations not generally described in textbooks or articles. Descriptions are included for labiaplasty, including clitoral hood reduction, majoraplasty, monsplasty, and perineoplasty with vaginoplasty. Reduction of anesthetic risks, deep venous thromboses, and pulmonary emboli are discussed, with special consideration for avoidance of nerve injury and compartment syndrome. Postoperative care of a variety of vulvovaginal procedures is discussed. Videos showing anatomic variations and surgical techniques of common female genital procedures with recommendations to reduce the complication rate are included in the article.

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“…We report the case of a 54-year-old male patient with a recent history of polytrauma (1 month before), and was referred to our institute because of an extended perineal and left gluteal defect of 18 × 25 cm. Following the high energy trauma, the patient presented hemodynamic instability on a pelvis open book frac-Acute limb ischemia following perineal reconstruction in lithotomy position: take-home message for plastic surgeons Gianluca Sapino 1 , Sebastien Deglise 2 , Wassim Raffoul 1 , Pietro G. di Summa 1 Departments of 1 Plastic, Reconstructive and Hand Surgery and 2 Vascular Surgery, University Hospital of Lausanne (CHUV), University of Lausanne, Lausanne, Switzerland Despite the extensive use of lithotomy position in several plastic surgery procedures, most reports regarding the related incidence of complications are presented in the urologic, gynecologic, and anesthesiologic fields. We present the case of a 54-year-old male patient.…”

Section: Casementioning

confidence: 99%

“…If some potentially catastrophic complications, such as deep venous thrombosis (DVT) or even compartmental syndrome of the limb, have been described and are well documented in literature [2,3], acute arterial thrombosis in such setting is highly rare and only occasionally reported [4,5]. Indeed, possible implications of prolonged lithotomy position are probably underestimated by plastic surgeons in their common practice.…”

Section: Introductionmentioning

confidence: 99%

Acute limb ischemia following perineal reconstruction in lithotomy position: take-home message for plastic surgeons

et al. 2021

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Despite the extensive use of lithotomy position in several plastic surgery procedures, most reports regarding the related incidence of complications are presented in the urologic, gynecologic, and anesthesiologic fields. We present the case of a 54-year-old male patient. polytrauma patient who underwent internal iliac artery embolization leading to extensive gluteal necrosis requiring: debridement, abdominoperineal resection and composite anterolateral thigh flap reconstruction with prolonged lithotomy position. The patient presented lower limb ischemia briefly after surgical theater. A computed tomography scan revealed the obstruction of the left superficial femoral artery requiring emergency revascularization. Arterial thrombosis is a potentially devastating complication and plastic surgeons should be aware of the possible dangers when performing surgeries in prolonged lithotomy position. Preoperative detection of patients at high risks for developing complications should be performed in order to implement preventive measures and avoid potentially life-threatening sequelae.

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A systematic review of mechanical thromboprophylaxis in the lithotomy position

Cited by 10 publications

References 25 publications

Thromboprophylaxis in gynaecology: a review of current evidence

Thromboprophylaxis in gynaecology: a review of current evidence

The Safe Practice of Female Genital Plastic Surgery

Acute limb ischemia following perineal reconstruction in lithotomy position: take-home message for plastic surgeons

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