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4CPS-015 Situational analysis of postoperative iron supplementation prescriptions in a plastic surgery department
  1. S Cesbron1,
  2. P Gendre1,
  3. P Nizet1,
  4. C Letort2,
  5. JF Huon1,
  6. N Serandour1,
  7. J Moquard1,
  8. E Corbineau1,
  9. AS Fanuel Remoue1
  1. 1University Hospital, Pharmacy, Nantes, France
  2. 2University Hospital, Plastic Surgery Department, Nantes, France


Background and importance Following the computerisation of prescriptions in the plastic surgery department of our hospital, some protocols have been modified, leading to an increase in iron supplementation (IS) prescriptions by anaesthetists in postoperative care.

Aim and objectives The aim of our study was to perform an inventory of iron prescriptions and administrations in order to assess their relevance

Material and methods A retrospective analysis was performed from 29 January 2019 to 29 August 2019. Compliance of IS administrations with preoperative prescriptions and biological examinations was assessed. The local protocol recommended first intention use of iron saccharose hydroxide (ISH) when possible (due to the cost of ferric carboxymaltose (FCM)) and also defined the relevant biological parameters to achieve these administrations (1 g of FCM or two injections of 300 mg ISH separated by a 48 hour interval if haemoglobin <12 g/dL and ferritin <100 μmol/L or ferritin <600 μmol/L and transferrin saturation factor <0.2).

Results Sixty-nine IS prescriptions were collected, of which 32 (46%) were followed by an administration. The average length of stay (ALS) for patients was 2.8 days. Of these 69 prescriptions, 27 (39%) were not associated with the prescription of an iron biology (IB). Twenty-two administrations of ISH, 7 of FCM, 1 of ferrous fumarate and 2 of ferrous sulphate, were performed. Of these 32 administrations, 21 (66%) were justified by the IB. For the 11 others, the IB was incomplete. Of the 22 patients who received ISH, 18 (82%) received only one postoperative dose.

Conclusion and relevance In agreement with the protocol, ISH was mainly prescribed. Nevertheless, the ALS of the patients was incompatible with the administration recommendation. We note that in each case where an IB was complete, an IS was justified in postoperative care. This work will be followed by a consultation with the anaesthetists. Reflection on the dose and galenic of IS in relation to the iron deficiency calculation for each patient would be interesting in the context of a possible improved recovery programme after surgery.

References and/or acknowledgements No conflict of interest.

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