Key result
Continued use of antiplatelet and anticoagulant medications in the perioperative period of dermatologic surgery is generally recommended, though novel oral anticoagulants may increase bleeding risk.
Why the study?
Bleeding is an unavoidable risk of dermatologic surgery that may be higher in patients taking agents affecting hemostasis, prompting an updated review of current therapies and associated bleeding risks.
What is the risk of bleeding complications associated with continuing anticoagulant and antiplatelet therapy during dermatologic surgery?
What is the risk of bleeding complications associated with continuing anticoagulant and antiplatelet therapy during dermatologic surgery?
Current evidence supports continuing most antiplatelet and anticoagulant agents during dermatologic surgery, though caution is advised with novel oral anticoagulants and combination therapies.
Supports individualized bleeding risk assessment with antithrombotics during cutaneous surgery; leaves open need for agent-specific prospective data.
BACKGROUND: Bleeding is an unavoidable risk of dermatologic surgery. The risk may be higher in patients taking agents that affect hemostasis. OBJECTIVE: The aim of this study was to provide an updated review of current anticoagulant and antiplatelet therapy available in the market and their associated risk of bleeding complications in cutaneous surgery. MATERIALS AND METHODS: A review of PubMed and MEDLINE was performed to review the English-language medical literature. RESULTS: Many anticoagulant and antiplatelet therapies exist. Several studies recommend the continued use of antiplatelet and anticoagulant medications in the perioperative period. Combination regimens and novel oral anticoagulants may be associated with an increased risk of bleeding. CONCLUSION: An updated understanding of antiplatelet and anticoagulant agents is critical for the surgeon. Current evidence does not support the discontinuation of antiplatelet and anticoagulant agents in the perioperative period under most circumstances. However, relevant data on novel oral anticoagulant agents are still sparse, suggesting that a precautionary approach is warranted.
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Iyengar et al. (2019) conducted a review in Bleeding in dermatologic surgery. Anticoagulant and antiplatelet therapy was evaluated on Bleeding complications. Continued use of antiplatelet and anticoagulant medications in the perioperative period of dermatologic surgery is generally recommended, though novel oral anticoagulants may increase bleeding risk.
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