Utility of the Caprini risk assessment model in guiding venous thromboembolism prophylaxis after abdominoplasty.

[INTRODUCTION] Abdominoplasty carries a significant risk of venous thromboembolism (VTE). Two main strategies have been described for prophylaxis: systematic administration of low molecular weight heparin (LMWH) and risk-stratified management using the Caprini score. This study aimed to assess thromboembolic risk in abdominoplasty patients and compare the cost-effectiveness of a Caprini-based strategy with routine prophylaxis.

[METHODS] A retrospective review was performed on 219 patients who underwent abdominoplasty at a university plastic surgery unit where systematic LMWH prophylaxis was standard. Demographic data, Caprini score components, complications, and costs were analyzed, and a cost-effectiveness comparison between systematic LMWH and a Caprini-based approach was performed.

[RESULTS] The mean Caprini score was 3.3 ± 1.1 (range 1-10). All patients received LMWH for a mean of 14.9 ± 1.5 days. One patient (0.45 %) developed pulmonary embolism, and 13 (5.9 %) developed hematomas. Cost analysis indicated that a risk-stratified approach could reduce LMWH expenditure by 44.5 %.

[CONCLUSIONS] Applying the Caprini score for VTE prophylaxis in abdominoplasty may reduce unnecessary anticoagulation and associated complications, while generating substantial cost savings for centers that do not currently use this model.