INDIVIDUALIZED PROPHYLAXIS OF VENOUS THROMBOEMBOLIC COMPLICATIONS IN COMBINED ABDOMINOPLASTY AND MAMMAPLASTY IN A PATIENT WITH CONGENITAL THROMBOPHILIA: A CLINICAL CASE
DOI:
https://doi.org/10.32782/2411-9164.24.1-1Keywords:
surgery, plastic surgery, abdominoplasty, mammoplasty, multimodal anesthesia, general anesthesia, enoxaparin, thromboprophylaxis, thrombosis, hemostasisAbstract
The article presents a clinical case of combined abdominoplasty and mammoplasty in a 36-year-old patient with congenital thrombophilia (APC resistance), varicose vein disease, and recurrent miscarriage, who had previously successfully carried a pregnancy only under enoxaparin prophylaxis. Based on the Caprini 2005 model, the patient was classified as very high VTE risk, which necessitated individualized perioperative thromboprophylaxis including mechanical methods (elastic compression, intraoperative pneumatic compression, early mobilization) and pharmacological prophylaxis with enoxaparin 40 mg subcutaneously 12 hours before surgery and for 7 days postoperatively. Combined McKissock mastopexy and abdominoplasty with rectus abdominis diastasis repair (duration 6 hours) proceeded without intraoperative or postoperative thrombotic or hemorrhagic complications, with primary wound healing. The case demonstrates that, with thorough risk stratification and individualized thromboprophylaxis, major aesthetic surgeries can be safely performed in patients with severe thrombotic and obstetric history.
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