{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T07:05:12Z","timestamp":1792739112819,"version":"4.5.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T00:00:00Z","timestamp":1716940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T00:00:00Z","timestamp":1716940800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Plast Surg (Oakv)"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>\n                    <jats:bold>Introduction:<\/jats:bold>\n                    Given the aging population, plastic surgeons are increasingly faced with the challenge of balancing procedural bleeding risk with thromboembolic risk in patients receiving antithrombotic therapies undergoing elective procedures. Guideline recommendations remain unclear in this population, which contributes to heterogeneity in clinical practices. We present a practical approach that summarizes guideline recommendations to facilitate the perioperative management of patients requiring surgery who are already on antithrombotic agents.\n                    <jats:bold>Methods:<\/jats:bold>\n                    Due to the scarcity of plastic surgery-specific guidelines, recommendations were primarily adapted from the 2022 American College of Chest Physicians guidelines on perioperative management of antithrombotic therapy as they are recognized as authoritative and widely used in clinical practice.\n                    <jats:bold>Results:<\/jats:bold>\n                    A clinical practice conceptual framework was adapted based on preexisting guidelines, dividing decision-making into 3 steps: (1) assessing the procedural bleeding risk; (2) assessing the patients\u2019 thromboembolic risk; and (3) determining appropriate management according to antithrombotic agent type. Specific indications are provided for continuing, stopping, and bridging anticoagulants and antiplatelet agents, as well as for consultation with a cardiologist or hematologist.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    The present framework can be implemented in plastic surgeons\u2019 clinical practice to guide the management of patients on antithrombotic therapies, while minimizing nonessential referrals to the thrombosis service. The lack of plastic surgery-specific guidelines on this topic highlights a need for further research to \u201cbootstrap\u201d the risk categorization of plastic surgical procedures and their appropriate perioperative management.\n                  <\/jats:p>","DOI":"10.1177\/22925503241256654","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T03:18:40Z","timestamp":1716952720000},"page":"677-683","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Perioperative Management of Antithrombotic Therapy in Patients Undergoing Plastic and Reconstructive Surgery: A Practical Tool Based on Current Guidelines"],"prefix":"10.1177","volume":"33","author":[{"given":"Tara","family":"Behroozian","sequence":"first","affiliation":[{"name":"Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0034-0753","authenticated-orcid":false,"given":"Evan","family":"Fang","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Douketis","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene","family":"Retrouvey","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8348-2863","authenticated-orcid":false,"given":"Achilles","family":"Thoma","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada"},{"name":"Department of Health Research Methods, Evidence and Impact (HEI) McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,5,29]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2016-310581"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.1997.tb00065.x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/IOP.0b013e31827f599e"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2022.07.025"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/IOP.0000000000001652"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2014.1147"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/ddg.14579"},{"issue":"1","key":"e_1_3_2_9_2","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1111\/j.1610-0387.2012.08003.x","article-title":"Management of anticoagulation during dermatosurgical procedures in Germany\u2014results from a cross-sectional study","volume":"11","author":"Nast A","year":"2013","unstructured":"Nast A, Ernst H, Rosumeck S, Erdmann R, Sporbeck B, Fluhr JW. Management of anticoagulation during dermatosurgical procedures in Germany\u2014results from a cross-sectional study. J Dtsch Dermatol Ges J Ger Soc Dermatol JDDG. 2013;11(1):52\u201359. doi:https:\/\/doi.org\/10.1111\/j.1610-0387.2012.08003.x","journal-title":"J Dtsch Dermatol Ges J Ger Soc Dermatol JDDG"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3109\/2000656X.2015.1029935"},{"issue":"3","key":"e_1_3_2_11_2","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1111\/ddg.13459","article-title":"Management of antithrombotic agents in dermatologic surgery before and after publication of the corresponding German evidence-based guideline","volume":"16","author":"Gaskins M","year":"2018","unstructured":"Gaskins M, Dittmann M, Eisert L, et al. Management of antithrombotic agents in dermatologic surgery before and after publication of the corresponding German evidence-based guideline. JDDG J Dtsch Dermatol Ges. 2018;16(3):297\u2013305. doi:https:\/\/doi.org\/10.1111\/ddg.13459","journal-title":"JDDG J Dtsch Dermatol Ges"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cll.2014.06.006"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000006465"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/IOP.0000000000002058"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.3109\/2000656X.2014.967254"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2020.6.46415"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00238-005-0721-7"},{"issue":"7","key":"e_1_3_2_18_2","first-page":"766","article-title":"Distinct approaches to perioperative management of anticoagulation and antiplatelet therapy among providers performing cutaneous surgery","volume":"21","author":"Han J","year":"2022","unstructured":"Han J, von Csiky-Sessoms S, Owji S, et al. Distinct approaches to perioperative management of anticoagulation and antiplatelet therapy among providers performing cutaneous surgery. 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