252 Plastic Surgery Venous Thromboprophylaxis for Abdominal and Thigh Based Free Flap Breast Reconstruction Surgery

Abstract Aim Correct Venous Thromboprophylaxis (VTE) assessment and prescription is at basis of patient safety when considering patient hospital admission. Current local Guy's and St Thomas Hospital guidelines are in keeping with National Institute for Health and Care Excellence (NICE) guidelines recommending all patients to be assessed and prescribed VTE prophylaxis within 24 hours of admission. There are no specific local or national guidelines however that would recommend VTE prophylaxis specific to free flap breast reconstruction surgery. We assessed therefore adherence to VTE prophylaxis guidelines for patients undergoing abdominal and thigh based free flap breast reconstruction surgery. Patient outcomes were reviewed and VTE prophylaxis proforma was recommended. Method Patients who underwent abdominal or thigh based free flap breast reconstruction surgery between October 2017 and February 2019 were identified. Data was collected retrospectively and analysed via SPSS Statistics (IBM, USA). Results 51 patients were included in the first audit cycle; 50 patients in the re-audit. Overall improvement and 100% of patients received LMWH on admission. The timings of correct prescription versus actual administration of LMWH decreased however from 71% to 49%. Conclusion There is good adherence to assessment and administration of VTE prophylaxis across the patients. Unfortunately, the prescription of VTE prophylaxis itself is mostly incorrect. It is therefore with gratitude to the ward staff VTE is administered correctly. Further improvements in the communication therefore between theatre, ward and surgical staff and implementation of VTE prophylaxis proforma need to be considered.