Why the study?
There is wide variability and a lack of specific guidelines regarding whether to temporarily cease or continue oral anticoagulants and antiplatelet agents in patients requiring hand and wrist surgery.
This review summarizes current literature and recommendations for balancing the risks of bleeding and thromboembolism when managing antithrombotic therapy in patients undergoing hand and wrist surgery.
Variability in antithrombotic management for hand/wrist surgery persists without guidelines; leaves open need for standardized, evidence-based protocols.
There is wide variability in the management of patients on antithrombotic therapy requiring surgery of the hand and wrist. There are no specific guidelines regarding whether to temporarily cease or continue oral anticoagulants and antiplatelet agents. Discontinuation of these medications before surgery can lead to perioperative thromboembolic or ischemic events. On the other hand, continuation can lead to intraoperative or postoperative bleeding complications. This review discusses various anticoagulants and antiplatelet agents with special considerations for their management, analyzes the current literature, summarizes current recommendations, and provides direction for additional research.
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Gallant et al. (2023) studied this question.
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