Don't stop antithrombotics for cutaneous surgery: just do it now!

Prospective multicentre cohort study on 9154 surgical procedures to assess the risk of postoperative bleeding – a DESSI study

“…To date, there is no available standardized approach for dealing with patients receiving antithrombotic agents prior to surgical procedures on the skin, although the number of patients taking blood thinners is steadily increasing …”

“…The perioperative management of patients taking anticoagulation therapy is a challenge for all surgical specialties, and physicians are confronted with the decision of whether to continue or discontinue drugs …”

“…The perioperative management of patients taking anticoagulation therapy is a challenge for all surgical specialties, and physicians are confronted with the decision of whether to continue or discontinue drugs. [1][2][3][4][5][6][7] The standard anticoagulation therapy after placement of coronary artery stents is clopidogrel and acetylsalicylic acid (ASA), which is also used for patients with unstable angina or after a non-ST-segment elevation myocardial infarction. [8][9][10] Phenprocoumon or warfarin is often used after thrombosis or pulmonary embolism and may be combined with ASA for patients with mechanical heart valves.…”

An Update for UK Podiatrists Performing Toenail Surgery on Patients Who Are Taking Antithrombotic Medications: It’s About Bleeding Time

“…It is assumed that the reader is familiar with coagulation physiology and therefore a precis of the pathways is outside the scope of this document. For the patient on antithrombotic medication, the risk comes down to the following dichotomy: cease the medication and risk the formation of a thrombosis; or continue the medication and run the risk of a complication from bleeding 18,19 . Should continuation of pharmacotherapy be the strategy, the practitioner must minimise and manage the haemorrhagic risk 20 (see Fig.…”

Anticoagulantes na prática cirúrgica dermatológica

“…8,11,12 No entanto, é muito bem documentado o aumento do risco de eventos tromboembólicos associados à interrupção de medicações anticoagulantes. 17,18,19 A magnitude de potenciais eventos que apresentam morbimortalidade elevada sobrepõe em muito o risco de complicações hemorrágicas no sítio cirúrgico para cirurgia dermatológica. Portanto, a consulta pré-cirúrgica realizada adequadamente com ênfase ao histórico clínico do paciente (incluindo função renal nos casos de uso dos novos anticoagulantes orais), a localização anatômica abordada e a exata programação do tratamento cirúrgico são essenciais para um desfecho adequado.…”