The safety of open inguinal herniorraphy in patients on chronic warfarin therapy.
BACKGROUND
The perioperative management of warfarin therapy increases the complexity of open inguinal herniorraphy.


METHODS
One thousand consecutive patients undergoing open inguinal herniorraphy were retrospectively reviewed. Patients on warfarin therapy were categorized into 3 groups: continued warfarin (CW), discontinued warfarin (DW), and discontinued warfarin with anticoagulation bridge (DWB).


RESULTS
Eighty-eight patients were on chronic warfarin therapy. Warfarin was continued in 19 patients, discontinued in 54, and discontinued with bridge in 15 patients. Operative times were similar between the 3 groups. Length of stay was longest in the discontinued warfarin with bridge group (CW 0.74, DW 0.54, and DWB 3.33 days; P < .0001). There was no significant difference in postoperative complications. The incidence of surgical site hematoma was higher in the continued warfarin and discontinued warfarin with bridge groups (CW 11%, DW 2%, and DWB 13%; P = .14).


CONCLUSIONS
Continuation of warfarin may be a safe alternative to discontinuation of warfarin therapy in select patients undergoing open inguinal herniorraphy.
McLemore
Elisabeth C
EC
Department of Surgery, Mayo Clinic Arizona, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA.
Harold
Kristi L
KL
Cha
Stephen S
SS
Johnson
Daniel J
DJ
Fowl
Richard J
RJ
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013923:Thromboembolism / Q000517:prevention & control; D016896:Treatment Outcome; D014859:Warfarin / Q000009:adverse effects*
D000925:Anticoagulants; D014859:Warfarin