{"doi":"10.1002/jso.28030","title":"Perioperative Venous Thromboembolism Chemoprophylaxis Does Not Increase Risk of Complications in Free Flap Breast Reconstruction","abstract":"BACKGROUND: Patients undergoing abdominal-based free flap breast reconstruction are at risk for perioperative venous thromboembolism (VTE), but the optimal anticoagulation protocol remains unknown. We hypothesized that a standardized chemoprophylaxis protocol would minimize VTE events without increasing hematoma, flap loss, or reoperation. METHODS: A retrospective review was conducted on patients who underwent abdominal-based free flap breast reconstruction from 2010 to 2023. In 2015, we implemented an enhanced recovery after surgery (ERAS) protocol including preoperative enoxaparin. Patients with a BMI < 30 and > 30 received enoxaparin for 7 and 30 days postoperatively, respectively. 2010-2015 patients were pre-ERAS and 2015-2023 patients were the ERAS cohort. Patient demographics, comorbidities, and outcomes were analyzed. The primary outcomes were VTE, hematoma, flap loss, and reoperation. RESULTS: 2317 patients were included: 679 were pre-ERAS and 1638 were in the ERAS cohort. The incidence of deep vein thrombosis (0.7%) and pulmonary embolism (pre-ERAS 0.6% vs. ERAS 0.5%) was low in both cohorts with no significant differences. Hematoma (pre-ERAS 7.2% vs. ERAS 5.5%) and reoperation (pre-ERAS 7.8% vs. ERAS 9.7%) were similar, but the ERAS cohort had significantly lower flap failure (0.7% vs. 2.1%, p < 0.05). CONCLUSIONS: A standardized perioperative anticoagulation protocol for abdominal-based breast reconstruction maintained low VTE rates without increasing hematoma, flap failure, or reoperation.","journal":"Journal of Surgical Oncology","year":2024,"id":474689,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9657,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1206441,"name":"Uchechukwu O. Amakiri","orcid":null,"position":1,"is_corresponding":false},{"id":1304329,"name":"Jacob Levy","orcid":"0000-0003-0187-8336","position":2,"is_corresponding":false},{"id":902595,"name":"Ronnie L. Shammas","orcid":"0000-0001-5468-8646","position":3,"is_corresponding":false},{"id":1260291,"name":"Jonathan Rubin","orcid":"0009-0009-9413-5267","position":4,"is_corresponding":false},{"id":802893,"name":"Lillian A. Boe","orcid":"0000-0001-6279-9987","position":5,"is_corresponding":false},{"id":1141980,"name":"Evan Matros","orcid":"0000-0002-8864-4083","position":6,"is_corresponding":false},{"id":305284,"name":"Babak J. Mehrara","orcid":"0000-0001-5717-697X","position":7,"is_corresponding":false},{"id":434517,"name":"Robert J. Allen","orcid":"0000-0002-2959-109X","position":8,"is_corresponding":false},{"id":562846,"name":"Jonas A. Nelson","orcid":"0000-0003-0329-4422","position":9,"is_corresponding":false},{"id":1086488,"name":"Francis D. Graziano","orcid":"0000-0002-4746-1803","position":0,"is_corresponding":true}],"reference_count":33,"raw_metadata":null,"created_at":"2026-07-19T02:06:13.042906Z","pmid":"39635780","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}