DVT (Deep Venous Thrombosus), also known as VTE (Venous Thrombo Embolism), is a condition that results in the formation of blood clots in the deep veins of the calves, thighs or pelvis. Although the true incidence of DVT in the main population of plastic surgery patients is low, the risk does exist.
The hemostatic system in our bodies is always striving for constant equilibrium. Blood within our arteries and veins must be maintained in a fluid state so that it can circulate. At the same time, our systems must be able to convert liquid blood into a gel when some type of injury occurs to the blood vessel. This is known as “clot formation.” Clot formation occurs through two separation systems in our blood. The first involves cells known as platelets and the second involves clotting proteins. During clot formation, a series of chemical processes take place that can both activate and inactivate these platelets and clotting proteins. The triggers for these processes are quite simple and include:
1) Venous stasis (the blood in the veins is more sluggish than normal & does not flow swiftly)
2) Blood vessel wall damage (caused by inflammation, or trauma..such as a cut, surgical or otherwise)
3) Hypercoagulability (a state in which the bloods ability to form clots is heightened)
Venous stasis likely plays the major role in thrombus formation related to surgery. DVT can arise when the return flow of blood in veins is impaired. Both anesthesia and immobilization can cause venous stasis; anesthesia can do so by decreasing the tone of vein walls…and immobilization by placing a physical obstruction to returning blood flow. When venous return from the lower extremities is slowed during surgery, the decreased blood flow prevents the activated clotting factors from clearing as quickly as they normally would. This can lead to increased formation of venous clots, especially near the valves that live within the veins. Hypercoagulability is also known to contribute to the risk of clot formation. If you know or suspect that you may suffer from a condition that places you in a hypercoagulable state, be sure to alert Dr. Brenner of this information at the time of consultation prior to surgery.