Perioperative Management of Anticoagulation and Antiplatelet Therapy for Cutaneous Surgery: Different Approaches Among Dermatologic & Plastic and Reconstructive Surgeons

Published: 1 July 2021| Version 1 | DOI: 10.17632/zg3k8yrtb2.1
Stephanie von Csiky-Sessoms,
Christopher Yao,
Ellen Marmur


Background: Despite increasing cross-collaboration between providers who perform cutaneous surgery, a disparity still exists in the current practices regarding perioperative management. This could lead to treatment delays and increased morbidity, such as bleeding, infection, and discomfort of patients. Objective: To characterize the perioperative management practices of anticoagulation and antiplatelet therapy of providers who specialize in performing cutaneous surgeries Methods: This study surveyed current perioperative management practices of dermatologic surgeons and plastic and reconstructive surgeons. Results: 115 dermatologic surgeons and 62 plastic and reconstructive surgeons responded to the survey (response rate: 6.4%, 11.31%, respectively). For all therapeutic agents, dermatologic surgeons were significantly more likely than their plastic and reconstructive surgery colleagues to continue all anticoagulant and antiplatelet agents perioperatively for cutaneous surgery (vitamin K antagonists, antiplatelets, LMWH, direct Xa inhibitors, direct thrombin inhibitors, NSAIDS: p<0.001; fish oil, vitamin E: p<0.01). Limitations: This study was limited by a low response rate. Conclusion: Our data highlight the significant practice gaps that exist between dermatologic surgeons and plastic and reconstructive surgeons. Reducing this disparity will facilitate improved continuity of care, especially when patients are referred from dermatologic surgeons to plastic and reconstructive surgeons for more complex repairs.



Icahn School of Medicine at Mount Sinai


Plastic Surgery, Anticoagulation Therapy, Plastic Surgery after Neoplasm Surgery, Antiplatelet Agent, Dermatologic Surgery, Mohs Surgery