In:
Journal of the European Academy of Dermatology and Venereology, Wiley, Vol. 37, No. 9 ( 2023-09), p. 1906-1913
Kurzfassung:
Perioperative management of antiplatelet and anticoagulant (AP/AC) therapy is a matter of balancing the risks of bleeding and thromboembolic events. Reliable data for dermatosurgery are still lacking, especially for direct oral anticoagulants (DOAC). Objectives The aim was to prospectively evaluate the influence of AP/AC‐medication on bleeding risk in dermatosurgery with focus on exact intervals between DOAC intake and procedure performed on post‐operative bleeding. Methods Patients with or without AP/AC‐therapy were included in the study without randomization. Exact times of DOAC‐intake, procedure performed and post‐operative bleeding were documented. Data collection was prospectively and standardized done by one person. Results We evaluated 1852 procedures in 675 patients. Post‐operative bleeding occurred after 15.93% ( n = 295) of all procedures, but only a few of them were severe (1.57%, n = 29). Compared to patients without AP/AC‐medication, severe post‐operative bleeding occurred significantly more often under dual antiplatelet therapy (11.76%, n = 2; p = 0.0166) and bridging of either vitamin K antagonist (9.09%, n = 2; p = 0.0270) or DOAC (15.38%, n = 2; p = 0.0099). There was no significant difference in the frequency of severe bleeding regarding to the preoperative DOAC‐free period. Conclusions Although AP/AC‐therapy is associated with a significant higher rate of post‐operative bleeding, no life‐threatening bleeding was recorded. Long preoperative pausing or bridging of DOAC does not lead to significantly less severe bleeding events.
Materialart:
Online-Ressource
ISSN:
0926-9959
,
1468-3083
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2023
ZDB Id:
2022088-1
