SCD and Blood Thinners?

Using sequential compression stockings during surgery is standard care during most operations and especially during a tummy tuck.  The use of blood thinners has not been standardized and you should defer to the advice and experience f your surgeon.  Personally, I do not use post op blood thinners. Hope this helps.

    Based upon the Caprini risk assessment model, patients are stratified according to risk.  Patients in higher risk groups may need Lovenox or something similar to help with the prevention of blood clots.  Sequential compression devices are used in every tummy tuck patient.

It sounds like your surgeon is doing an excellent job of managing your risk of VTE.  His management knowledge of this risk factor is very up to date and quite sound. Use of SCD's during surgery of a moderate risk like TT's protects you while reducing the risk of bleeding intra-operatively.  Use of chemoprophylaxis 6-12 hours after surgery gives you protection with a lower risk of bleeding.  The precise length of time to continue the blood thinners is not yet known as it relates to Plastic Surgery.  Any where from 1-4 weeks would be reasonable depending on your risk factors.  Good luck!

The answer to your question depends on multiple factors, so the answer may be different for each patient. The risk of deep venous thrombosis and pulmonary embolus is based on risk stratification. You may check out the risk factors at the link below. If you are still unsure, ask your surgeon to calculate your Caprini score.

 

SCD and blood thinners lower the risk (not prevent) of blood clot formation (DVT) and pulmonary embolism.  In cosmetic surgery, patients are otherwise healthy and we are not so concerned about your heart and lungs during and after surgery, but about blood clots as potentially dangerous.  Blood clots in deep veins (Deep Venous Thrombosis - DVT) is a potentially dangerous situation.  Most surgeons take preventative actions in surgeries where the risk of DVT is increased.  SCD and blood thinners can be used.  

Yes it is common to use blood thinners and SCD's for a tummy tuck.  When done under general anesthesia the muscle pumps in the calves and thighs relax and there is some blood pooling that increases the risk of DVT.  SCD's help to act as the muscle pump and blood thinners help prevent stagnant blood from clotting.

In my practice I most commonly do not use a general anesthesia for a tummy tuck and in my experience the risk of DVT is MUCH less.  I always use SCD's but almost never use blood thinners.  In 10 years of practice doing lots of tummy tucks I have only seen two DVT's, which is much less than what we should be seeing statistically.  

Patient safety is a plastic surgeon's number one priority. Any procedure performed under general anesthesia results in no patient movement (if you think about it, we move around a lot when we sleep at night), and this increases the risk  of blood clots forming in large veins in the legs and pelvis, which could then break away and travel to the lungs and cause breathing problems. Sequential Compression Devices (SCDs) are pumps that wrap around the calves of the legs to squeeze blood out of the legs to prevent blood clots. We use SCDs on all patients to decrease the risk of blood clots.

Blood thinners also work to decrease the risk of blood clots forming in the legs or pelvis. There are risks of bleeding associated with blood thinners and so careful selection of at risk patients is necessary. We generally use blood thinners for surgeries performed under general anesthesia that last more than 2 hours.

Patient safety is our first priority at the Centre for Plastic Surgery. Careful use of common devices and medicines will help to keep patients safe. 

It is common to use SCD's--sequencial compression devices--during tummy tuck surgery to try to maintain normal-like blood flow in the leg veins. During general anesthesia, that flow which is somewhat dependent upon muscle contractions, is rather diminished. 

The goal is to minimize the chances of blood clots which could break off the leg veins and travel through the heart to the lungs causing serious medical problems. 

Further protection in selected patients can be attained with blood thinners. Some surgeons use them in all TT patients. Most use them selectively in higher risk patients using what is called a "Caprini score." You can google this term for more info, and also discuss this with your surgeon. These medicines carry a risk of bleeding which must be balanced against the benefits of less clotting in the leg veins. 

Thanks for your question, best wishes. 

Thanks, and best wishes.