Evidence map›Paper›PMID 41629469›Full record

SynthesisAesthetic plastic surgery2026

Cutting Through the Clot: Rethinking Venous Thromboembolism Prophylaxis in Plastic Surgery with Aspirin, Direct Oral Anticoagulants, and Low Molecular Weight Heparin.

Shannon Y Zhou, Jose Foppiani, Molly A Vance, Zeling Yu, Lacey Foster, Dominika Gavlasova, Elan Choudry, Gavin Lin, Daniah Alnafisee, Thomas Suszynski and 2 more

Abstract readMeta-AnalysisSystematic Review
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In one paragraph

Synthesis in Aesthetic plastic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Shannon Y Zhou *Division of Plastic and Reconstructive Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Jose Foppiani *Division of Plastic and Reconstructive Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.ORCID 0000-0003-2783-3531
Molly A VanceDivision of Plastic and Reconstructive Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Zeling YuDivision of Plastic and Reconstructive Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Lacey FosterDivision of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard University, 110 Francis St, Suite 5A, Boston, MA, 02215, USA.
Dominika GavlasovaBreck School, Golden Valley, MN, USA.
Elan ChoudryInstitute of Clinical and Experimental Medicine, 140 21, Prague, Czech Republic.
Gavin LinNorthwestern University, Chicago, IL, USA.
Daniah AlnafiseeDivision of Plastic and Reconstructive Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Thomas SuszynskiDivision of Plastic and Reconstructive Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Umar ChoudryDivision of Plastic and Reconstructive Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Samuel J LinDivision of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard University, 110 Francis St, Suite 5A, Boston, MA, 02215, USA. sjlin@bidmc.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVenous thromboembolism (VTE) remains a critical concern in plastic and reconstructive surgery (PRS) due to prolonged operative duration, perioperative immobility, and procedure-specific risks. While low-molecular-weight heparin (LMWH) has been the prophylactic standard, use of direct oral anticoagulants (DOACs) and aspirin (ASA) has been gaining traction. This study summarizes prophylactic practices in PRS.

methodsA systematic search of three databases was conducted. Studies evaluating ASA, DOACs, or LMWH prophylaxis in PRS with VTE, bleeding, or 30-day reoperation rates were included. Mixed anticoagulant regimens were excluded. Data on dosage, duration, and complication rates were extracted. A random-effect meta-analysis of proportions was conducted.

resultsOf 884 studies screened, 7 met inclusion criteria, totaling 3,475 patients: ASA (n=402), DOACs (n=2056), and LMWH (n=802). Common regimens included ASA 325mg daily for 5 days and DOAC 10mg daily for 10 days; LMWH dosing varied. VTE rates were low across groups: 1.15% ASA, 0.3% DOACs, and 0.44% LMWH. Hematoma rates were similar for ASA (4.6%) and LMWH (4.5%), while DOACs had a higher rate (8.7%), largely influenced by an outlier. Reoperation rate was highest for ASA (16.9%), followed by DOACs (10.5%) and LMWH (8.0%).

conclusionDespite comparable VTE rates across agents, variability in bleeding and reoperation highlights the need for procedure-specific, individualized prophylaxis. ASA and LMWH may offer more predictable safety profiles, while DOACs remain promising but warrant further investigation LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Indexed as

AnticoagulantsAspirinHeparin, Low-Molecular-WeightPlastic Surgery ProceduresPostoperative ComplicationsVenous ThromboembolismAdministration, OralDrug Administration ScheduleFemaleHumansMaleReoperationRisk AssessmentTreatment OutcomeAnticoagulantsAspirinHeparin, Low-Molecular-WeightAspirinDirect oral anticoagulantsLow molecular weight heparinPostoperative complicationsThromboprophylaxisVenous thromboembolism

Identifiers

PMID41629469

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.