Plastic Surgery Venous Thromboprophylaxis for abdominal and thigh based free flap breast reconstruction surgery

World Congress on SURGERY, SURGEONS AND ANESTHESIA

November 29-30, 2021 Webinar

Inez Eiben

St Thomas Hospital, UK

Scientific Tracks Abstracts: J Surgery

Abstract :

Aims Correct Venous Thromboprophylaxis (VTE) assessment and prescription is at basis of patient safety when considering patient hospital admission. Current local Guy’s and St Thomas Hospital guidelines are in keeping with National Institute for Health and Care Excellence (NICE) guidelines recommending all patients to be assessed and prescribed VTE prophylaxis within 24 hours of admission. There are no specific local or national guidelines however that would recommend VTE prophylaxis specific to free flap breast reconstruction surgery. Most surgeons recommend first dose of low molecular weight heparin (LMWH) to be administered at 6-12 hours post operatively. We assessed therefore adherence to VTE prophylaxis guidelines for patients undergoing abdominal and thigh based free flap breast reconstruction surgery. Patient outcomes were reviewed and VTE prophylaxis proforma was recomended. Methods Patients who underwent abdominal or thigh based free flap breast reconstruction surgery between October 2017 and February 2018 were identified through Electronic Patient Record and theatre booking system Galaxy (iSOFT, Australia). Data were collected retrospectively and analysed via SPSS Statistics (IBM, USA). Data was re-audited between October 2018 and February 2019. Results 51 patients were included in the first audit cycle; 50 patients in the re-audit. Overall improvement and 100% of patients received LMWH on admission. The timings of correct prescription versus actual administration of LMWH decreased however from 71% to 49%. Discussion There is good adherence to assessment and administration of VTE prophylaxis across the patients. Unfortunately the prescription of VTE prophylaxis itself is mostly incorrect. It is therefore with gratitude to the ward staff VTE is administered correctly. Further improvements in the communication therefore between theatre, ward and surgical staff and implementation of VTE prophylaxis proforma need to be considered.

Biography :

Inez Eiben is a Speciality Registrar in Plastic Surgery. She is currently working at St Thomas Hospital in London where she can cultivate her passion for plastic surgery