[Perioperative thromboprophylaxis--for the immobilisation period, potential extension beyond hospitalisation].
Antithrombotic prophylaxis of venous thromboembolism after surgery, usually by means of subcutaneous administration of(low-molecular-weight) heparin, drastically reduces the incidence of postoperative thrombosis and pulmonary embolism. Therefore, this intervention is advocated in various national and international guidelines. A questionnaire-based study in this issue shows that 99% of surgeons in the Netherlands strictly adhere to these guidelines. Interestingly, the duration of thromboprophylaxis is much less clear and is usually restricted to the duration of hospitalisation. In view of the increasing number of surgical procedures in short-stay or even outpatient settings, it is possible that extended prophylaxis for perioperative thrombosis should be considered, particularly in patients with risk factors for thrombosis, such as the presence of malignant disease.
Levi
M
M
Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Inwendige Geneeskunde, onderafd, Vasculaire Geneeskunde, F-4, Meiberg- dreefg, 1105 AZ Amsterdam. m.m.levi@amc.uva.nl
Hoppener
M R
MR
D000925:Anticoagulants / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D013503:Surgery Department, Hospital / Q000592:standards*; D011795:Surveys and Questionnaires; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight