Prospective evaluation of dermatologic surgery complications including patients on multiple antiplatelet and anticoagulant medications

摘要: Background Few prospective studies have evaluated the safety of dermatologic surgery. Objective We sought to determine rates bleeding, infection, flap and graft necrosis, dehiscence in outpatient surgery, examine their relationship type repair, anatomic location antibiotic use, antiplatelet or anticoagulant use. Methods Patients presenting University Massachusetts Medical School Dermatology Clinic for surgery during a 15-month period were prospectively entered. Medications, procedures, complications recorded. Results Of 1911 patients, 38% on one medication, 8.0% on two more. Risk hemorrhage was 0.89%. Complex repair (odds ratio [OR] = 5.80), (OR = 7.58), 11.93), partial 43.13) more likely result bleeding than intermediate repair. both clopidogrel warfarin 40 times all others ( P  = .03). infection 1.3%, but greater 3% genitalia, scalp, back, leg. Partial necrosis occurred 1.7% flaps, 8.6% grafts. 20% grafts scalp 10% nose. All resolved without sequelae. Limitations The study limited academic dermatology practice. Conclusion rate is low, even when multiple oral medications are continued, prophylactic antibiotics not used. Closure use increase risk. However, these should be continued avoid adverse thrombotic events.