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Antithrombotic treatment and risk of complications after head and neck full thickness skin graft surgery

Hasselgren, Martin; Runer, Thomas; Janson, Peter and Ekström, Magnus LU (2018) In Journal of Plastic Surgery and Hand Surgery2010-01-01+01:00 52(6). p.333-337
Abstract

Head and neck skin cancer surgery using a full thickness skin graft is a common procedure. Evidence concerning the effects of perioperative antithrombotic treatment on complications is limited. The aim of this study was to evaluate whether perioperative antithrombotic treatment is associated with risk of necrosis, bleeding or infection after full thickness skin graft surgery. Retrospective single-center cohort study with medical records review. Patients operated with a head and neck full thickness skin graft in 2010 and 2013–2015 had available data and were included. Any antithrombotic treatment was continued and all patients were routinely followed-up on days 7–10 after surgery. Data on demographics, concurrent disease, clinical... (More)

Head and neck skin cancer surgery using a full thickness skin graft is a common procedure. Evidence concerning the effects of perioperative antithrombotic treatment on complications is limited. The aim of this study was to evaluate whether perioperative antithrombotic treatment is associated with risk of necrosis, bleeding or infection after full thickness skin graft surgery. Retrospective single-center cohort study with medical records review. Patients operated with a head and neck full thickness skin graft in 2010 and 2013–2015 had available data and were included. Any antithrombotic treatment was continued and all patients were routinely followed-up on days 7–10 after surgery. Data on demographics, concurrent disease, clinical characteristics, antithrombotic medications and postoperative necrosis, bleeding and infection were collected from electronic medical records. Associations with complications were examined using multivariate logistic regression adjusted for age, sex, reoperation, size of excision, site of surgery and concurrent disease. In total, 302 patients (53% women) were included. Antithrombotic treatment (n = 125 patients) was not associated with higher adjusted risk of total complications in multivariate analysis (OR 0.70; 95% CI: 0.34–1.46). In subgroup analyses, the total risk was not increased in patients on aspirin (OR 0.76; 95% CI: 0.39–1.48) or warfarin (OR 1.20; 95% CI: 0.47–3.10). In the warfarin subgroup (N = 26), there was a statistically non-significant trend towards increased risk of graft necrosis. This study supports that aspirin and warfarin should not be discontinued prior to head and neck full thickness skin graft surgery.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
antithrombotics, aspirin, Full thickness skin graft, head and neck skin cancer, warfarin
in
Journal of Plastic Surgery and Hand Surgery2010-01-01+01:00
volume
52
issue
6
pages
333 - 337
publisher
Taylor & Francis
external identifiers
  • scopus:85053335273
ISSN
2000-656X
DOI
10.1080/2000656X.2018.1498789
language
English
LU publication?
yes
id
551a6a4a-4d9f-4c4d-b7ee-2b9140c801c5
date added to LUP
2018-10-24 08:55:56
date last changed
2019-02-20 11:33:07
@article{551a6a4a-4d9f-4c4d-b7ee-2b9140c801c5,
  abstract     = {<p>Head and neck skin cancer surgery using a full thickness skin graft is a common procedure. Evidence concerning the effects of perioperative antithrombotic treatment on complications is limited. The aim of this study was to evaluate whether perioperative antithrombotic treatment is associated with risk of necrosis, bleeding or infection after full thickness skin graft surgery. Retrospective single-center cohort study with medical records review. Patients operated with a head and neck full thickness skin graft in 2010 and 2013–2015 had available data and were included. Any antithrombotic treatment was continued and all patients were routinely followed-up on days 7–10 after surgery. Data on demographics, concurrent disease, clinical characteristics, antithrombotic medications and postoperative necrosis, bleeding and infection were collected from electronic medical records. Associations with complications were examined using multivariate logistic regression adjusted for age, sex, reoperation, size of excision, site of surgery and concurrent disease. In total, 302 patients (53% women) were included. Antithrombotic treatment (n = 125 patients) was not associated with higher adjusted risk of total complications in multivariate analysis (OR 0.70; 95% CI: 0.34–1.46). In subgroup analyses, the total risk was not increased in patients on aspirin (OR 0.76; 95% CI: 0.39–1.48) or warfarin (OR 1.20; 95% CI: 0.47–3.10). In the warfarin subgroup (N = 26), there was a statistically non-significant trend towards increased risk of graft necrosis. This study supports that aspirin and warfarin should not be discontinued prior to head and neck full thickness skin graft surgery.</p>},
  author       = {Hasselgren, Martin and Runer, Thomas and Janson, Peter and Ekström, Magnus},
  issn         = {2000-656X},
  keyword      = {antithrombotics,aspirin,Full thickness skin graft,head and neck skin cancer,warfarin},
  language     = {eng},
  month        = {11},
  number       = {6},
  pages        = {333--337},
  publisher    = {Taylor & Francis},
  series       = {Journal of Plastic Surgery and Hand Surgery2010-01-01+01:00},
  title        = {Antithrombotic treatment and risk of complications after head and neck full thickness skin graft surgery},
  url          = {http://dx.doi.org/10.1080/2000656X.2018.1498789},
  volume       = {52},
  year         = {2018},
}