Local Pro- and Anti-Coagulation Therapy in the Plastic Surgical Patient: A Literature Review of the Evidence and Clinical Applications

The risks of systemic anti-coagulation or its reversal are well known but accepted as necessary under certain circumstances. However, particularly in the plastic surgical patient, systemic alteration to hemostasis is often unnecessary when local therapy could provide the needed adjustments. The aim...

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Bibliographic Details
Published in:Medicina (Kaunas, Lithuania) Lithuania), 2019-05, Vol.55 (5), p.208
Main Authors: Oliver, Jeremie D, DeLoughery, Emma P, Gupta, Nikita, Boczar, Daniel, Sisti, Andrea, Huayllani, Maria T, Restrepo, David J, Hu, Michael S, Forte, Antonio J
Format: Article
Language:English
Subjects:
anti-coagulation
Anticoagulants - adverse effects
Anticoagulants - pharmacology
Anticoagulants - therapeutic use
Blood Coagulation - drug effects
coagulation
drug delivery
flaps
Hemostasis - drug effects
Humans
local therapy
plastic surgery
Reconstructive Surgical Procedures - methods
Review
Tranexamic Acid - pharmacology
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Summary:The risks of systemic anti-coagulation or its reversal are well known but accepted as necessary under certain circumstances. However, particularly in the plastic surgical patient, systemic alteration to hemostasis is often unnecessary when local therapy could provide the needed adjustments. The aim of this review was to provide a summarized overview of the clinical applications of topical anti- and pro-coagulant therapy in plastic and reconstructive surgery. While not a robust field as of yet, local tranexamic acid (TXA) has shown promise in achieving hemostasis under various circumstances, hemostats are widely used to halt bleeding, and local anticoagulants such as heparin can improve flap survival. The main challenge to the advancement of local therapy is drug delivery. However, with increasingly promising innovations underway, the field will hopefully expand to the betterment of patient care.
ISSN:1648-9144
1010-660X
1648-9144
1010-660X
DOI:10.3390/medicina55050208