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Scientific Oral Presentations

Facial Plastic and Reconstructive Surgery

Session: Scientific Oral Presentations 3 - Facial Plastic and Reconstructive Surgery

Aspirin Monotherapy for Deep Vein Thrombosis Prophylaxis Among Head and Neck Free Flap Surgeries

Tuesday, October 1, 2024
11:06 AM – 11:12 AM EDT
Location: MBCC, 222
Disclosure(s):
Melodyanne Y. Cheng, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Keith E. Blackwell, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Head and neck free flap surgeries typically utilize postoperative anticoagulation options, such as heparin or enoxaparin monotherapy, or dual heparin and aspirin, for prophylaxis against adverse thrombosis-associated outcomes and flap protection. This study aimed to evaluate the overall rates of deep vein thrombosis (DVT), pulmonary embolism (PE), and hematoma formation in free flap patients at a tertiary care center treated with aspirin monotherapy against rates of published large series data for patients treated by gold standard anticoagulation protocols.

Methods: This study consisted of a retrospective chart review. Incidents of post-operative PE, DVT, and hematoma formation were assessed in patients who underwent free flap procedures at a major urban tertiary care center in Southern California. Rates of postsurgical outcomes of PE, DVT, and hematoma formation were compared to other studies in the literature. Preliminary statistical analyses of the dataset were done by Excel to calculate incidence rates of postoperative events in the study population.

Results: 949 patients underwent free flap head and neck surgeries between 2013 and 2022. 942 were adults aged 18 years or older, and 7 were pediatric patients under the age of 18. The average (± standard deviation) age of patients in this study was 64 (± 15 years). 614 of the patients were male and 335 were female. Out of the total 949 patients, there were 29 postoperative incidents of DVTs (3.1%), 15 postoperative incidents of PE (1.6%), 7 postoperative incidents of hematoma formation (0.7%), 5 flap thrombosis events (0.5%), and 1 flap failure (0.1%).

Conclusions: The DVT rate in 949 free flap patients on aspirin-monotherapy was equal to rates of published large series data on gold standard prophylaxis, while the hematoma formation rate of aspirin-monotherapy patients was among the lowest of rates published. Therefore, this study demonstrated aspirin alone is sufficient monotherapy for DVT prophylaxis.

    Presenting Author(s)

  • Melodyanne Y. Cheng, MS

    MS4
    David Geffen School of Medicine
    Los Angeles, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • ML

    Manwel Labib, MS

    UCLA David Geffen School of Medicine, United States

    Disclosure information not submitted.

  • AD

    Arman Danielian, MD, MS

    Resident
    UCLA Head and Neck Surgery
    Los Angeles , California, United States

    Disclosure information not submitted.

  • SH

    Song Hon Hwang, MD

    Resident Physician
    UCLA - Head & Neck Surgery
    Los Angeles, CA, United States

    Disclosure information not submitted.

  • VN

    Vishad Nabili, MD

    Professor & Vice Chair
    UCLA Head and Neck Surgery Dept., Division of Facial Plastic Surgery
    Los Angeles, California, United States

    Disclosure information not submitted.

  • KB

    Keith E. Blackwell, MD

    Professor of head and neck surgery
    UCLA David Geffen School of Medicine
    Los Angeles, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Rhorie P. Kerr, MD

    Assistant Professor of Facial Plastic and Reconstructive Surgery
    Eastern Virginia Medical School
    Norfolk, VA, United States

    Disclosure information not submitted.


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