Postoperative Komplikationen bei dermatochirurgischen Patienten im Rahmen der stationären mikroskopisch‐kontrollierten Chirurgie: Eine monozentrische epidemiologische Studie

Artamonova, Inga; Schmitt, Laurenz; Yazdi, Amir S.; Megahed, Mosaad; Felbert, Verena von

doi:10.1111/ddg.14148_g

Cited by 1 publication

(5 citation statements)

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“…Based on this, we consider DOAC to have a similar impact on bleeding risk as other AP/AC‐drugs for dermatosurgical procedures. Data from Artamonova et al 3 speak in favour of a fixed intake regimen with 24‐h preoperative and 1‐hpost‐operative DOAC abstinence, in which no connection between anticoagulation and bleeding complications could be seen and, particularly, none of the DOAC patients showed bleeding complications. In contrast, Callahan et al 38 recommended continuing any AP/AC‐medication, including DOAC, due to risks associated with discontinuation.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of skin cancer as well as the proportion of patients with an indication for antiplatelet or anticoagulant (AP/AC) therapy increases with age, resulting in a high percentage of patients in dermatosurgery with haemostasis‐inhibiting medication 1–4 …”

Section: Introductionmentioning

confidence: 99%

“…the nose), wide extension of the defect and type of surgical technique 6,14 . It is also important to mention that bleeding complications in dermatosurgery have been identified as a risk factor for surgical site infections 3,15 …”

Section: Introductionmentioning

confidence: 99%

“…

The incidence of skin cancer as well as the proportion of patients with an indication for antiplatelet or anticoagulant (AP/AC) therapy increases with age, resulting in a high percentage of patients in dermatosurgery with haemostasisinhibiting medication. [1][2][3][4] The first German S3 guideline for the management of AP/ AC in dermatosurgery was published 2015, stating that antiplatelet therapy (AP) and dual antiplatelet therapy (DAPT) should be continued perioperatively. 5 Vitamin K antagonists (VKA) should also be continued with an International Normalized Ratio (INR) in the therapeutic range without bridging with low-molecular-weight heparin (LMWH).

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mentioning

confidence: 99%

“…6,14 It is also important to mention that bleeding complications in dermatosurgery have been identified as a risk factor for surgical site infections. 3,15 This study evaluated the incidence of bleeding complications and perioperative management of DOAC in a reallife setting, and specifically examines the influence of the preoperative DOAC-free period on the risk of post-operative bleeding.…”

mentioning

confidence: 99%

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Influence of perioperative antiplatelet and anticoagulant medication management on bleeding events in dermatosurgery—A prospective observational study

Höper,

Rosen,

Kofler

et al. 2023

Acad Dermatol Venereol

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BackgroundPerioperative management of antiplatelet and anticoagulant (AP/AC) therapy is a matter of balancing the risks of bleeding and thromboembolic events. Reliable data for dermatosurgery are still lacking, especially for direct oral anticoagulants (DOAC).ObjectivesThe aim was to prospectively evaluate the influence of AP/AC‐medication on bleeding risk in dermatosurgery with focus on exact intervals between DOAC intake and procedure performed on post‐operative bleeding.MethodsPatients with or without AP/AC‐therapy were included in the study without randomization. Exact times of DOAC‐intake, procedure performed and post‐operative bleeding were documented. Data collection was prospectively and standardized done by one person.ResultsWe evaluated 1852 procedures in 675 patients. Post‐operative bleeding occurred after 15.93% (n = 295) of all procedures, but only a few of them were severe (1.57%, n = 29). Compared to patients without AP/AC‐medication, severe post‐operative bleeding occurred significantly more often under dual antiplatelet therapy (11.76%, n = 2; p = 0.0166) and bridging of either vitamin K antagonist (9.09%, n = 2; p = 0.0270) or DOAC (15.38%, n = 2; p = 0.0099). There was no significant difference in the frequency of severe bleeding regarding to the preoperative DOAC‐free period.ConclusionsAlthough AP/AC‐therapy is associated with a significant higher rate of post‐operative bleeding, no life‐threatening bleeding was recorded. Long preoperative pausing or bridging of DOAC does not lead to significantly less severe bleeding events.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%