Hold coumadin for skin surgery?

[Marty]

Need Vascular Surgeon

Need Vascular Surgeon

Jim, There is a surgical subspecialty called vascular surgery. These fellows are general surgeons first and then take extra training specifically in fixing damaged and stopped up arteries and veins in the neck, chest, abdomen, and extremities. They not only know all about blood vessels but they also know about coagulation and hemostasis. If your PCP does not know who is certified in this area call the hospital professional services office and they should give you two or three names. All the best.

 

[JimL]

Blanche, my PCP sent me to a dermatologist last summer; he prescribed a different antibiotic than the PCP had, which worked for a while.

Thanks, Marty, for the recommendation of the vascular surgeon. I spoke with a doctor friend this morning, and he said he knows of several surgeons who do skin surgery without holding coumadin, so things look good. I'll have to speak further with the current surgeon's staff this week, and take it from there.

 

[Guest]

I just found this. Give your doctor this reference.

Kovich, O. Thrombotic complications related to discontinuation of warfarin and aspirin therapy perioperatively for cutaneous operation. J m Acad Dermatol 2003 Feb;48 (2 Pt 2):233-237 (any librarian can look this up)

The authors are from Mayo Clinic in Rochester, Minnesota. They found (in a poll of 168 doctors) that when warfarin was withheld before skin surgery the risk of a clot doubled from 1 in 13,000 to 1 in 6,000. The clotting events were strokes, heart attacks, TIAs, DVT, PE, 1 clot in the eye leading to blindness and 3 deaths.

There was no increase in severe bleeding complications.

The authors call this, "a compelling argument to keep patients on medically necessary blood thinners during cutaneous operation."

 

[JimL]

Wow, Al, thanks for the reference. This restores all the options I started with. Thanks for the support.