The Likelihood of Wound Complications Following the Use of Rivaroxaban as a Thrombo-Prophylactic Agent in Patients Undergoing Spinal Canal Stenosis Surgery: A Case Series

Mohammadreza Golbakhsh; Mohammad Jamshidof; Amir Heydari; Parham Talebiyan; Salar Baghbani; Mazaher Ebrahimian; Mohammad Rastegar

doi:10.18502/jost.v8i4.10454

Mohammadreza Golbakhsh Associate Professor, Department of Orthopedics, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Jamshidof General Practitioner, Department of Orthopedics, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Amir Heydari Resident, Department of Orthopedics, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Parham Talebiyan Orthopedic Surgeon, Department of Orthopedics, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Salar Baghbani Resident, Department of Orthopedics, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Mazaher Ebrahimian Resident, Department of Orthopedics, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Rastegar Resident, Department of Orthopedics, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jost.v8i4.10454

Keywords: Cohort Studies; Postoperative Complication; Spine; Surgery; Wounds

Abstract

Background: Wound complications are major morbidities after orthopedic surgery, and thrombo-prophylactic drugs may increase the likelihood of such complications. In this regard, our study has evaluated the possible effects of rivaroxaban on wound complication issues following spinal canal stenosis surgery.

Methods: This prospective cohort study was conducted on 40 patients suffering from spinal canal stenosis secondary to degenerative lumbar spine changes. The eligible patients included those patients receiving rivaroxaban to prevent thrombo-emboli post-operatively. The patients were followed up for three months and assessed for postoperative wound-related complications.

Results: None of the patients suffered vascular and thromboembolic complications. Regarding wound complications, these events are mostly limited to the first week post-operatively, including wound dehiscence in 5.0%, serosanguineous discharge in 25.0%, erythema in 35.0%, superficial infection in 10.0%, requiring surgical debridement in 5.0%, cellulitis in 10.0%, and wound induration in 30.0%. Deep infection or hematoma was not reported in our patients. Erythema and wound induration remained 10.0% and 15.0% within the second week, respectively. The hypertrophic scar was a delayed complication that appeared in 15.0% of patients within 1 to 3 months post-operatively.

Conclusion: The main risk profiles related to wound complications, especially infections, were a history of hypertension (HTN), uncontrolled diabetes mellitus (DM), and renal insufficiency. The use of rivaroxaban may be accompanied by temporary and minor wound complications and not with potentially debilitating morbidity in patients undergoing spinal canal stenosis surgery. Therefore, its prescription as a safe thrombo-prophylactic drug in patients undergoing spinal canal stenosis surgery is confidently recommended.