COMPLICATIONS OF CUTANEOUS SURGERY IN PATIENTS WHO ARE TAKING WARFARIN, ASPIRIN, OR NONSTEROIDAL ANTIINFLAMMATORY DRUGS

Background and Design: No controlled studies exist with regard to the risks of continuing therapy with warfarin sodium or platelet inhibitor s or the benefits of briefly discontinuing therapy with these agents i n patients who are undergoing cutaneous surgical procedures. Our objec tive was to determine the frequency of complications of cutaneous surg ery in patients who were receiving warfarin or platelet inhibitors and to evaluate whether preoperative discontinuation reduces complication s. A retrospective, controlled study was performed of complications of excisional and Mohs micrographic surgery in 653 patients who were bei ng treated with warfarin or platelet inhibitors or with their medicati ons being briefly withheld. Results: Severe complications of cutaneous surgery in patients who are taking warfarin or platelet inhibitors ar e uncommon, occur in 1.6% of cases, and are not significantly increase d compared with complications in control subjects. Furthermore, there was no statistically significant reduction in the rates of severe comp lications in patients who had their medications preoperatively held.Co nclusion: Cutaneous surgery in patients who receive warfarin or platel et inhibitors is associated with a low risk of severe complications, n ot significantly reduced by brief preoperatively discontinuation.