Abdominal Craniectomy Implantation and Thromboembolism Prophylaxis Resulting in Wound Hematoma.
Fargen, Kyle M. MD, MPH; Bhasin, Rohit R. MD; Murad, Gregory J. MD
67(2):495-497, August 2010.
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BACKGROUND: Refractory intracranial hypertension often is treated with craniectomy to prevent herniation and irreversible neurologic decline in those with salvageable brain injuries.
OBJECTIVE: We report 3 cases of iatrogenic abdominal hematoma at the site of craniectomy implantation secondary to abdominal subcutaneous deep vein thrombosis (DVT) prophylaxis.
METHODS: A retrospective chart review of patients with abdominal wound complications after craniectomy and abdominal bone flap implantation at the University of Florida from 2004 to 2008 was performed.
RESULTS: Three patients receiving subcutaneous DVT prophylaxis via abdominal injections developed hematomas at the site of abdominal implantation. The hematomas occurred 17 days, 20 days, and 6 weeks postoperatively. All required urgent hematoma evacuation. All had evidence of needle sticks overlying the implantation site.
CONCLUSION: To reduce the potential risk of wound hematoma, DVT prophylaxis injections should be performed remote to the surgical site in craniectomized patients with abdominal bone flap implantation.
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