Surgical flight syndrome: how to reduce the risks

Doctors and their patients should exercise caution and, in some instances, take special measures to prevent serious medical problems that could result from airline travel in the period preceding or following a surgical procedure, says the American Society for Aesthetic Plastic Surgery (ASAPS) .

“Most people know that all surgery carries some risk,” says Peter Fodor, President of the American Society for Aesthetic Plastic Surgery (ASAPS). “What is less well known is that airline travel carries risk. So people who combine the two need to take extra precautions,” he says.

Deep vein thrombosis/pulmonary embolism (DVT/PE) is commonly referred to as “economy class syndrome” because the condition has been associated with cramped airline seating. (DVT occurs when blood clots develop within veins; PE occurs when blood clots within veins break off and are trapped in the lungs.) The precise cause of the condition is unknown, because there are numerous risk factors. The most common risk factors include: prolonged immobilization or bed rest, obesity, oral contraceptives, varicose veins, an underlying malignancy and surgery.

Airline travel also increases the risk of DVT/PE due to factors such as limited leg room and long periods of inactivity, dehydration from low humidity in the cabin, and the effects of high altitude which can decrease oxygen absorption into the blood.

Women are generally more vulnerable to DVT/PE than men. The more risk factors, the more susceptible one is to an occurrence of DVT/PE.

“Airline travel and surgery can potentially work together to increase the risk of DVT/PE,” says Alan Matarasso, MD, senior scientific editor of Aesthetic Surgery Journal , ASAPS' peer reviewed publication, and author of a past editorial on this issue.

Nevertheless, patients may travel safely after undergoing surgical procedures if certain precautions are taken. ASAPS offers the following guidelines to help prevent problems associated with airplane travel:

• If possible, avoid any air travel the first few days after major surgery.
• Avoid carrying heavy luggage for several weeks after surgery.
• Drink plenty of water. It is recommended that 8 ounces of water be consumed for each hour of airplane travel.
• Avoid dehydrating agents such as caffeine and alcohol
• Perform in-seat exercises. Get up and walk around the cabin as frequently as possible.
• Wear loose-fitting clothes and avoid surgical compression binders.

Inform your physician and surgeon of any planned extended airline travel. In some cases, physicians may recommend additional measures to further reduce risks. Taking proper precautions with airline travel before and after surgery can help to ensure patient safety.

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