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Adequate hydration, lower extremity elevation during, after surgery prevents DVT in abdominoplasty

Researchers recommend adequate hydration and lower extremity elevation during and after abdominoplasty to help prevent deep vein thrombosis.

Researchers studied 450 consecutive full abdominoplasties performed at one community surgery center from 1976 to 2013 by a single surgeon, John E. Keiter, MD, FACS.

Patients who underwent mini-abdominoplasty or transverse rectus abdominis flap breast reconstruction were excluded from the study.

All patients had general anesthesia and had follow-up visits at 1, 2 and 4 weeks after surgery.

One week before surgery, patients discontinued the use of aspirin and anti-inflammatory products.

While on the operating table, patients were placed into the moderate Trendelenburg position to improve lower extremity venous return.

Foley catheters were used to monitor each patient’s hydration during the surgery and postoperatively.

During the surgery the jackknife position was avoided. Patients’ urine was monitored and IV fluids were adjusted as needed to maintain a goal of 30 cc to 50 cc per hour

During recovery and overnight, patients maintained a feet-elevated, head-down position.

For 2 weeks following surgery, patients were able to move about frequently and to rest with feet elevated; they were restricted from sitting except for eating and to use the bathroom.

There were no clinically symptomatic pulmonary embolisms and no deaths. One patient who had undergone multiple procedures developed a calf deep vein thrombosis (DVT).

She was placed on Coumadin (warfarin, Bristol-Myers Squibb) therapy and experienced good results. This case corresponded to an overall rate of 0.22% for DVT at 30 days following surgery.

A low fluid volume state, or dehydration, can lead to hemoconcentratoin and low venous flow, according to researchers.

A strict routine of adequate hydration and lower extremity elevation during and after surgery decreases rates of DVT for abdominoplasty patients, the researchers concluded. – by Abigail Sutton

Disclosure: The researchers reported no relevant financial disclosures.