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2026, Number 1

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Cir Plast 2026; 36 (1)

Prevention of bleeding in plastic surgery

Domínguez-Millán R

Language: Spanish
References: 86
Page: 64-75
PDF size: 400.10 Kb.


ABSTRACT

Hemorrhagic complications continue to be a critical determinant of morbidity and mortality in plastic surgery, despite their low overall incidence. This review analyzes incidence, patient-related and perioperative risk factors, and evidence-based strategies for bleeding prevention in plastic, aesthetic, and reconstructive surgery. Major factors associated with bleeding include comorbidities such as uncontrolled hypertension, obesity, preoperative anemia, smoking, advanced age, complex and/or combined procedures, as well as the use of antiplatelet agents, anticoagulants, dietary supplements, and herbal products with antiplatelet or anticoagulant effects. Evidence supports a multifactorial preventive approach with emphasizes thorough preoperative risk assessment, exclusion of bleeding history, and appropriate suspension or management of medications and supplements that alter hemostasis. Pharmacological interventions, particularly the use of tranexamic acid, along with optimization of preoperative hemoglobin, strict blood pressure control, wise use of topical hemostatic agents, and meticulous surgical technique, have consistently demonstrated reductions in intraoperative blood loss, transfusion rates, and hematoma formation. The application of structured, evidence-based protocols is essential to improve patient safety and optimize surgical outcomes.


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