Aspirin Management for Wound Debridement

General Recommendations

• The American Heart Association recommends continuing aspirin 75-100 mg in patients with prior PCI undergoing noncardiac surgery to reduce cardiac events 2
• Aspirin continuation reduces major cardiac events by up to 80% in high-risk patients without excess bleeding in most surgical settings 4
• Discontinuing antiplatelet therapy increases stroke recurrence risk by 2.02% and cardiovascular events by 1.83% within 30 days 3, 4, 5

Special Populations

• Patients with coronary stents should continue aspirin regardless of stent timing if dual antiplatelet therapy (DAPT) must be interrupted 2
• Patients with recent stroke or TIA should continue aspirin to prevent recurrent ischemic events 3, 4, 5
• Patients with peripheral arterial disease should continue aspirin as these patients have high cardiovascular event risk perioperatively 5

Risk Stratification

• Patients on aspirin for secondary prevention (history of MI, stroke, peripheral arterial disease, or coronary stents) should continue aspirin through the procedure 3, 4, 5
• The 2024 AHA/ACC guidelines recommend continuing aspirin in patients with coronary disease 2

Critical Pitfalls to Avoid

• Do NOT bridge with heparin or LMWH when discontinuing aspirin—this increases bleeding risk without preventing thrombotic events 3, 4
• Do NOT routinely discontinue aspirin for all procedures—this outdated practice increases mortality and morbidity 1
• Do NOT delay resumption of aspirin postoperatively—restart within 12-24 hours unless active bleeding 6