ELEVATED ACTIVATION MARKERS OF COAGULATION IN PATIENTS UNDERGOING ORTHOGNATHIC SURGERY

Surgery is associated with a variable but increased incidence of posto perative venous thromboembolism (VTE). The risk of VTE after orthognat hic surgery is unknown. Recently developed assays for activation marke rs of blood coagulation allow the detection of a prethrombotic state a nd may thus help to identify surgical procedures with a risk of postop erative VTE. The pre- and postoperative levels of thrombin-antithrombi n complex (TAT) and prothrombin fragment 1+2 (F1+2) were studied in te n patients undergoing orthognathic surgery. Mean levels of TAT and F12 were within the normal range preoperatively (TAT:2.6+1.0 mu g/L, F12:0.8+0.2 nmol/L). A significant increase in both parameters occurred postoperatively (TAT:21.8+21.4 mu g/L, P<0.005; F1+2:1.3+0.4, P<0.02). No increase was observed in a control group (n=13) consisting of pati ents undergoing minor surgical procedures in general anesthesia. Our s tudy shows that a marked activation of the coagulation cascade occurs during orthognathic surgery which warrants further studies on the true incidence of postoperative VTE in patients undergoing orthognathic su rgery.