Importance of postoperative hydration and lower extremity elevation in preventing deep venous thrombosis in full abdominoplasty: A report on 450 consecutive cases over a 37-year period

Abstract

Background: Abdominoplasty is a common plastic surgery procedure and has a higher rate of postoperative deep venous thrombosis (DVT) than any other such surgery. DVT prevention remains an important topic in the plastic surgery community. Many surgeons avoid DVT chemoprophylaxis, because they are concerned about the risk of postoperative bleeding. Objective: This study was performed in order to evaluate postoperative hydration and lower extremity elevation as two alternative methods of aiding DVT prevention after abdominoplasty. Methods: Preoperative, intraoperative, and postoperative measures were taken to monitor patient hydration via urine output and to ensure adequate hydration by providing intravenous fluids. In addition, measures were taken throughout these three phases to ensure adequate lower extremity elevation. Results: In a group of 450 consecutive full abdominoplasties from 1976 to 2013, the overall rate of patient DVT at 30 days following surgery was 0.22%. Conclusions: Hydration and lower extremity elevation are innocuous and risk-free adjuncts that improve venous return from the legs and lessen the chance of postoperative DVT.