Postoperative bleeding risk for cutaneous surgery in the head and neck region with continued phenprocoumon therapy
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Postoperative bleeding risk for cutaneous surgery in the head and neck region with continued phenprocoumon therapy. / Eichhorn, Wolfgang; Barsukov, Evgeny; Al-Dam, Ahmed; Gröbe, Alexander; Smeets, Ralf; Eichhorn, Marc; Heiland, Max; Kluwe, Lan; Blessmann, Marco.
In: J CRANIO MAXILL SURG, Vol. 42, No. 5, 2014, p. 608-611.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Postoperative bleeding risk for cutaneous surgery in the head and neck region with continued phenprocoumon therapy
AU - Eichhorn, Wolfgang
AU - Barsukov, Evgeny
AU - Al-Dam, Ahmed
AU - Gröbe, Alexander
AU - Smeets, Ralf
AU - Eichhorn, Marc
AU - Heiland, Max
AU - Kluwe, Lan
AU - Blessmann, Marco
N1 - Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
PY - 2014
Y1 - 2014
N2 - In a total of 171 surgical procedures for lesions in the head and neck region in patients in whom phenprocoumon therapy was not stopped, 16 (9%) postoperative bleeding events were observed over a follow-up period of two weeks. Local measures were sufficient in all cases except one severe case where blood transfusion was needed and anticoagulant treatment was stopped for 7 days. The bleeding risk was significantly higher for the surgical procedures of the nose than those in other areas (21% versus 6%, P = 0.014), but was not influenced by the international normalized ratio (INR) of blood coagulation, size, site and type of the lesion, surgical procedure, and sex and age of the patients. The bleeding rate in patients not on any anticoagulation therapy was significantly lower (6/211 = 3%). Across both groups, just over 80% of the bleeding episodes were within the first two days (55% on the same day and 32% on the next day) of the surgery. No bleeding was recorded after 5 days. Our data suggest that cutaneous surgery in the head and neck region can be safely performed with continued phenprocoumon therapy in most cases in an INR range of 1.3-3.4, but rarely severe bleeding does occur and can be managed with a close-contact follow-up and with 24-h on call services during the first two days postoperatively.
AB - In a total of 171 surgical procedures for lesions in the head and neck region in patients in whom phenprocoumon therapy was not stopped, 16 (9%) postoperative bleeding events were observed over a follow-up period of two weeks. Local measures were sufficient in all cases except one severe case where blood transfusion was needed and anticoagulant treatment was stopped for 7 days. The bleeding risk was significantly higher for the surgical procedures of the nose than those in other areas (21% versus 6%, P = 0.014), but was not influenced by the international normalized ratio (INR) of blood coagulation, size, site and type of the lesion, surgical procedure, and sex and age of the patients. The bleeding rate in patients not on any anticoagulation therapy was significantly lower (6/211 = 3%). Across both groups, just over 80% of the bleeding episodes were within the first two days (55% on the same day and 32% on the next day) of the surgery. No bleeding was recorded after 5 days. Our data suggest that cutaneous surgery in the head and neck region can be safely performed with continued phenprocoumon therapy in most cases in an INR range of 1.3-3.4, but rarely severe bleeding does occur and can be managed with a close-contact follow-up and with 24-h on call services during the first two days postoperatively.
U2 - 10.1016/j.jcms.2013.08.006
DO - 10.1016/j.jcms.2013.08.006
M3 - SCORING: Journal article
C2 - 24103463
VL - 42
SP - 608
EP - 611
JO - J CRANIO MAXILL SURG
JF - J CRANIO MAXILL SURG
SN - 1010-5182
IS - 5
ER -
