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Neurosurgery. 2010 Aug;67(2):495-7. doi: 10.1227/01.NEU.0000371982.19935.21.

Abdominal craniectomy implantation and thromboembolism prophylaxis resulting in wound hematoma.

Author information

1
Department of Neurosurgery, University of Florida College of Medicine, Gainesville, Florida 32610-0265, USA. kyle.fargen@neurosurgery.ufl.edu

Abstract

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.

[Indexed for MEDLINE]

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