Venous Thromboembolism Prophylaxis in Aesthetic Surgery: A Survey of Plastic Surgeons' Practices.

BACKGROUND: Deep venous thrombosis (DVT) and pulmonary embolism (PE), collectively known as venous thromboembolism (VTE), are among the most feared yet preventable surgical complications. While many recommendations exist to reduce the risk of VTE, the actual VTE prophylaxis practices of aesthetic plastic surgeons remain unknown. OBJECTIVES: The primary aim of this study was to elucidate plastic surgeons' experiences with VTE, preferred VTE prophylaxis practices and areas in which VTE prevention may be improved. METHODS: Members of The American Society for Aesthetic Plastic Surgery (ASAPS) were queried via a 55-question electronic survey regarding their experience with VTE as well as their VTE prophylaxis practices. Anonymous responses were collected and analyzed by the Mayo Clinic Survey Research Center. RESULTS: The survey was sent to 1729 ASAPS members, of whom 286 responded. Fifty percent, 38%, and 6% of respondents reported having had a patient develop a DVT, PE, or death secondary to VTE. Procedures performed on the back or trunk were associated with the highest rate of VTE. Lower extremity procedures were associated with a significantly higher rate of VTE than expected. Over 90% of respondents reported using a patient risk stratification assessment tool. Although at least half of respondents reported that the surgical facility in which they operate maintains some form of VTE prophylaxis protocol, 39% self-reported non-adherence with these protocols. CONCLUSIONS: There is considerable variability in VTE prophylaxis practices among the ASAPS responders. Future efforts should simplify guidelines and tailor prophylaxis recommendations to the aesthetic surgery population. Furthermore, education of plastic surgeons performing aesthetic surgery and more diligent surgical venue supervision is needed to narrow the gap between current recommendations and actual practices.