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Review
. 2020 Feb;46(2):192-201.
doi: 10.1097/DSS.0000000000002266.

Update and Review of Bleeding Considerations in Dermatologic Surgery: Anticoagulants and Antiplatelets

Sanjana Iyengar  1 , Danielle G Yeager  2 , Joel L Cohen  3   4 , David M Ozog  2
Affiliations
Review

Update and Review of Bleeding Considerations in Dermatologic Surgery: Anticoagulants and Antiplatelets

Sanjana Iyengar et al. Dermatol Surg. 2020 Feb.

Abstract

Background: Bleeding is an unavoidable risk of dermatologic surgery. The risk may be higher in patients taking agents that affect hemostasis.

Objective: The aim of this study was to provide an updated review of current anticoagulant and antiplatelet therapy available in the market and their associated risk of bleeding complications in cutaneous surgery.

Materials and methods: A review of PubMed and MEDLINE was performed to review the English-language medical literature.

Results: Many anticoagulant and antiplatelet therapies exist. Several studies recommend the continued use of antiplatelet and anticoagulant medications in the perioperative period. Combination regimens and novel oral anticoagulants may be associated with an increased risk of bleeding.

Conclusion: An updated understanding of antiplatelet and anticoagulant agents is critical for the surgeon. Current evidence does not support the discontinuation of antiplatelet and anticoagulant agents in the perioperative period under most circumstances. However, relevant data on novel oral anticoagulant agents are still sparse, suggesting that a precautionary approach is warranted.

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References

    1. Henley J, Brewer JD. Newer hemostatic agents used in the practice of dermatologic surgery. Dermatol Res Pract 2013;2013:279289.
    1. Brown DG, Wilkerson EC, Love WE. A review of traditional and novel oral anticoagulant and antiplatelet therapy for dermatologists and dermatologic surgeons. J Am Acad Dermatol 2015;72:524–34.
    1. Collins SC, Dufresne RG Jr. Dietary supplements in the setting of mohs surgery. Dermatol Surg 2002;28:447–52.
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    1. Kimyai-Asadi A, Jih MH, Goldberg LH. Perioperative primary stroke: is aspirin cessation to blame? Dermatol Surg 2004;30:1526–8. discussion 1528-9.

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