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What is the role and optimal method of postoperative thromboprophylaxis in surgical patients?
What is the role and optimal method of postoperative thromboprophylaxis in surgical patients?
Low-molecular-weight heparins are the preferred and practical method for postoperative thromboprophylaxis, typically administered for about one week.
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May support LMWH for one-week postoperative prophylaxis; leaves open optimal regimens in high-risk subgroups.
Background: This review article actualizes the role of postoperative thromboprophylaxis and describes the methods available today. Material and Methods: The review is based on published research evidence together with the author''s experiences and opinions. Results: Risk factors are related to both the patient and the surgical procedure. In clinical praxis a simple risk factor classification is reasonable, where age and type of operation are the dominating factors. Of the pharmacological prophylactic methods available on the market, low-molecular-weight heparins and dextran are discussed in more detail, both concerning their benefits and drawbacks. Conclusion: The dominating method in thromboprophylaxis today is the administration of one of the low-molecular-weight heparins which are effective, safe, and practical. The duration of prophylaxis should be around one week. Infusion of dextran may be considered an alternative during short-stay surgery.
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D. Bergqvist (1999) studied this question.
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