Does Seven Days of Postoperative Enoxaparin Increase Bleeding Risk in Abdominal Contouring Surgery? A Single-center Experience

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Background: Venous thromboembolism (VTE) poses a major risk after abdominal contouring surgery, impacting morbidity and mortality. Despite various preventative strategies, surgeons are cautious about using enoxaparin for extended postoperative periods. This study aims to determine if a 7-day postoperative course of enoxaparin increases bleeding risks compared with a single dose of intraoperative unfractionated heparin in patients undergoing abdominal contouring surgery. Methods: A retrospective cohort analysis was performed on patients who underwent abdominoplasty or panniculectomy from August 2017 to October 2023. Patients were split into 2 groups: Group 1 received 5000 units of intraoperative unfractionated heparin in addition to 7 days of postoperative enoxaparin (40 mg daily); group 2 received only the intraoperative heparin dose. Primary outcomes included bleeding events and VTE incidence. Secondary outcomes were seroma, infection, surgical site dehiscence, necrosis, drain duration, and reoperation rates. Results: The study included 121 patients (111 women, 10 men), with 61 patients in group 1 and 60 in group 2. The average age was 49 ± 12 years, and the average body mass index was 29.8 ± 5 kg/m². No cases of VTE were reported. Postoperative bleeding occurred in 3 patients (4.9%) in group I and 2 patients (3.3%) in group 2, showing no statistically significant difference (P = 0.66). Secondary outcomes also showed no significant differences between the groups. Conclusions: Our study of 121 patients undergoing either abdominoplasty or panniculectomy demonstrated that administering enoxaparin for 7 days postoperatively is safe and does not increase the risk of bleeding.

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