Reducing Risk of Pulmonary Embolism

Like any surgical procedure, plastic surgery involves a certain degree of risk. In order to minimize these risks, it is important to follow the directions of your surgeon before, during, and after your medical treatment. Of particular focus in this article is an avoidable complication known as pulmonary embolism. This condition is essentially the blockage in the arteries of the lungs, usually due to the formation and release of blood clots from the legs or other parts of the body.

In relation to pulmonary embolism, there are certain increased risk factors that I must take into consideration when patients are coming to me for surgery, and there is a table below that shows those. However, I'd first like to share some activities and precautions that will significantly lower the risk of pulmonary embolism for everybody. In addition to the requirement of not smoking and avoiding second-hand smoke, I recommend that all patients:

· Drink plenty of water (3 liters per day at least).

· Avoid lying down during the days before surgery.

· During the flight, avoid sitting down for long periods of time, try walking around or moving your toes, feet, and legs all the time.

· Preferably buy compression stockings for your flight and preoperative days and wear them at all times.

Following these guidelines keeps the blood circulating at optimum levels. Doing so insures that any clotting will be minimized, making the risk of embolism much less likely. Thank you for remembering these points. It is especially important for those of you who may answer yes to one or more of the following risk factors.

Table for determining risk factors for Deep Venous Thrombosis (DVT) and Pulmonary Embolism 

Risk factor	YES	NO
Major surgery in the past month
Varicose veins
History of Inflammatory bowel disease
Swollen legs
Obesity (BMI above 25)
Heart infarction
Congestive heart failure
History of sepsis in last month
Severe pulmonary condition in the last month
Abnormal pulmonary function (COPD)
History of deep venous thrombosis or pulmonary thromboembolism
Family history of thrombosis
Blood disorders
Hip, leg, or pelvic fracture in the last month
Multiple myeloma
Oral contraceptives or hormonal replacement therapy
Pregnancy or less than 1 month since delivery
History of miscarriages (more than 3)