Unfractionated Heparins, Low-Molecular-Weight Heparins, and Indirect Factor Xa Inhibitors in Plastic and Reconstructive Surgery: An Evidence-Based Review.

Abstract

Venous thromboembolism can present with devastating complications and sequalae, particularly in the surgical patient. Current data supports prophylactic anticoagulant use in the high-risk inpatient, defined as those with a 2005 Caprini Risk Assessment Model score of ≥7. The most utilized chemoprophylaxis agents include unfractionated heparin, low-molecular-weight heparins, and indirect factor Xa inhibitors. The authors review their mechanisms of action, metabolism, reversal agents, indications, contraindications, advantages, and disadvantages in plastic and reconstructive surgery.