And they bleed a heck of a lot more on Plavix than Aspirin. This is probably the first article I’ve ever read out of Academic Dermatology, and it’s mildly relevant to EM in the sense that we perform a lot of minor cutaneous procedures – suturing, I&D, etc.
This is a retrospective review of bleeding associated with minor surgical dermatology, and, the good news, it was rare – at 0.3% of cases on clopidogrel, and even rarer on aspirin alone, and then zero when on neither. Bleeding doesn’t stress us out as much, probably, so this isn’t practice changing. They do importantly mention in their discussion that holding/changing these medications prior to the procedure can be associated with thrombotic complications – I wouldn’t be rushing off to give DDAVP to wake any platelets up if I ran into procedural troubles.
“Complications of cutaneous surgery in patients taking clopidogrel-containing anticoagulation.”
http://www.ncbi.nlm.nih.gov/pubmed/21514003