Association of Aspirin Use With Postoperative Hematoma and Bleeding Complications in Foot and Ankle Surgery: A Retrospective Study

Abstract

Discontinuation of nonsteroidal antiinflammatory drugs 3 to 5 days before elective or nonelective foot and ankle surgery has been recommended, as its continued use during the perioperative period may result in complications; however, data supporting this are limited. In this study, we evaluated the incidence of postoperative bleeding, hematoma formation, and wound dehiscence after perioperative aspirin ingestion before foot and ankle surgery. The medical records of 379 patients treated over a 3-year period were reviewed. Patient demographics, surgical procedures, affected limbs (right foot versus left foot), anatomical surgical sites (forefoot, midfoot, and rearfoot), and week 2 surgical site inspection data were recorded. Mean patient age was 60.12 (range 21 to 81) years, and the overall wound complication rate was 0.80%. The patients were classified into 2 groups: those who took 81 mg of aspirin preoperatively (n = 238, 62.80%) and those who did not (n = 141, 37.20%). Of the 3 patients who developed postoperative bleeding complications, 2 were taking aspirin and 1 was not. Patients taking aspirin had similar wound complication and healing rates as those not taking aspirin. Postoperative hematomas were evacuated in the clinic under sterile conditions and healed by secondary intention. Perioperative aspirin use appears to be safe and effective in foot and ankle surgery, and patients taking aspirin had good surgical outcomes with minimal postoperative complications.