ABPS Preoperative Assessment & Postoperative Care 2 — Questions and Answers
Question 1: Which lab value is most critical to check before elective plastic surgery in a patient on long-term warfarin therapy?
- Serum albumin
- INR (Correct answer)
- Platelet count
- Fibrinogen level
Correct answer: INR
INR must be within an acceptable range (typically <1.5) before elective surgery to minimize bleeding risk in patients on warfarin.
Question 2: A patient undergoing abdominoplasty is found to have a BMI of 38. What is the most appropriate next step?
- Proceed with surgery with modified technique
- Delay surgery and recommend weight loss to BMI <30 (Correct answer)
- Order additional cardiac workup only
- Prescribe compression garments preoperatively
Correct answer: Delay surgery and recommend weight loss to BMI <30
A BMI ≥35 significantly increases complication risk (DVT, wound dehiscence, infection), and delaying surgery until BMI is reduced to <30–32 is standard ABPS guidance.
Question 3: What is the recommended postoperative position for a patient following facelift surgery to reduce edema?
- Flat supine position
- Head of bed elevated 30–45 degrees (Correct answer)
- Prone position
- Lateral decubitus position
Correct answer: Head of bed elevated 30–45 degrees
Elevating the head of the bed 30–45 degrees reduces facial edema and venous pooling following rhytidectomy.
Question 4: Which of the following is a Caprini score component used to assess VTE risk in plastic surgery patients?
- Previous alcohol use
- History of prior DVT or PE (Correct answer)
- Chronic NSAID use
- Resting heart rate above 80 bpm
Correct answer: History of prior DVT or PE
Prior DVT or PE is a major Caprini risk factor and contributes significantly to the overall VTE risk score.
Question 5: A patient reports taking St. John's Wort herbal supplement. When should this be discontinued before elective surgery?
- 1 day before surgery
- 5 days before surgery
- At least 2 weeks before surgery (Correct answer)
- No discontinuation needed
Correct answer: At least 2 weeks before surgery
St. John's Wort should be stopped at least 2 weeks preoperatively due to its CYP450 induction, which can alter drug metabolism and increase bleeding risk.
Question 6: What is the most common postoperative complication following augmentation mammaplasty?
- Capsular contracture (Correct answer)
- Implant rupture
- Hematoma
- Infection
Correct answer: Capsular contracture
Capsular contracture is the most common long-term complication after breast augmentation, affecting approximately 10–20% of patients over time.
Question 7: Which factor is considered a contraindication for outpatient surgery in a plastic surgery patient?
- ASA Class I status
- Age under 65 with controlled hypertension
- Obstructive sleep apnea requiring CPAP (Correct answer)
- BMI of 28
Correct answer: Obstructive sleep apnea requiring CPAP
Moderate-to-severe obstructive sleep apnea requiring CPAP is a relative contraindication for outpatient plastic surgery due to postoperative airway risk.
ABPS Preoperative Assessment & Postoperative Care 2
Which lab value is most critical to check before elective plastic surgery in a patient on long-term warfarin therapy?