Journal article
The Effect of Anticoagulant and Antiplatelet Medications on Wide-Awake Hand Surgery: An Analysis of 2,162 Cases
The Journal of hand surgery (American ed.), v 49(10)
17 Jul 2024
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The purpose of the study was to determine if perioperative prescription anticoagulant (AC) or antiplatelet (AP) medication use increases the rate of revision surgeries or complications following wide-awake hand surgery performed under local anesthesia.
All patients who underwent outpatient wide-awake hand surgery under local anesthesia without a tourniquet by two fellowship-trained orthopedic hand surgeons at a single academic practice over a 3-year period were included. Prescription history was reviewed to determine if any prescriptions were filled for an AC/AP drug within 90 days of surgery. All cases requiring revision were identified. Office notes were reviewed to determine postoperative complications and/or postoperative antibiotics prescribed for infection concerns. The number of revisions, complications, and postoperative antibiotic prescriptions were compared between patients who did, and did not, use perioperative AC/AP drugs.
A total of 2,162 wide-awake local anesthesia surgeries were included, and there were 128 cases (5.9%) with perioperative AC/AP use. Of the 2,162 cases, 19 cases required revision surgery (18 without AC/AP use and one with AC/AP use). Postoperative wound complications occurred in 42 patients (38 without AC/AP use and four with AC/AP use). Of the wound complications, four were related to postoperative bleeding, one case of incisional bleeding, and three cases of incisional hematomas (three without AC/AP use and one with AC/AP use). None of these patients required additional intervention; their incisional bleeding or hematoma was resolved by their subsequent office visit. Sixty-five patients received postoperative antibiotics for infection concerns (59 without AC/AP use and six with AC/AP use).
Prescription AC/AP medication use in the perioperative period for wide-awake hand surgery performed under local anesthesia was not associated with an increased risk for revision surgery or postoperative wound complications. This study demonstrates the safety of continuing patients’ prescribed AC/AP medications during wide-awake hand surgery.
Prognosis IV.
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Details
- Title
- The Effect of Anticoagulant and Antiplatelet Medications on Wide-Awake Hand Surgery: An Analysis of 2,162 Cases
- Creators
- Kyle J. Plusch - Rothman InstituteChaim Miller - Thomas Jefferson UniversityKelsey Wood - Thomas Jefferson UniversitySamuel Alfonsi - Thomas Jefferson UniversityAmir R. Kachooei - Rothman InstituteJonas L. Matzon - Rothman InstituteAsif M. Ilyas - Rothman Institute
- Publication Details
- The Journal of hand surgery (American ed.), v 49(10)
- Publisher
- Elsevier; PHILADELPHIA
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:001332944200001
- Scopus ID
- 2-s2.0-85199136620
- Other Identifier
- 991021894439104721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Orthopedics
- Surgery