The full title of the article is “The Efficacy of Prophylactic Low-Molecular-Weight Heparin to Prevent Pulmonary Thromboembolism in Immediate Breast Reconstruction Using the TRAM Flap.” The full reference is below.
Malignancy causes a procoagulant state, with abnormalities in blood flow and vessel wall and blood composition. The overall risk of venous thrombosis was sevenfold higher in patients with malignancy than in persons without malignancy, and the risk of venous thrombosis was highest during the first few months after the diagnosis of malignancy. In breast cancer patients, the adjusted odds ratio for venous thrombosis is 4.9, and up to 15 percent of breast cancer patients present with venous thromboembolism during the course of their disease. Moreover, chemotherapy and hormone therapy, which are unavoidable, are significant precipitants of venous and arterial thrombosis.
Symptomatic thromboembolism was diagnosed in eight of the 450 group 1 patients (1.8 percent)Asymptomatic pulmonary thromboembolism was detected in nine of the 54 group 1c patients (16.7 percent) who underwent routine workup for pulmonary thromboembolism.Neither symptomatic nor asymptomatic pulmonary thromboembolism was diagnosed in group 2 patients.
Although the incidence of symptomatic pulmonary thromboembolism was lower in group 2, the difference was not statistically significant (p = 0.107). In contrast, the incidence of asymptomatic pulmonary thromboembolism was significantly lower in group 2c patients than in group 1c patients
Clinical observation showed that enoxaparin-treated patients had more apparent bruising at the operation sites and the subcutaneous injection sites.This is considered unavoidable, and meticulous hemostasis is required during every procedure throughout surgery, especially at the muscle stump and the deepithelialized flap surface.
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