[Prevention of postoperative thromboembolic complications with subcutaneously administered small doses of heparin]

Abstract

In a prospective study 3 x 5000 IU sodium heparin s.c. have been used for the prevention of postoperative deep vein thrombosis. Prevention started preoperatively in general surgical and urological patients. The diagnosis was made in all cases by means of the iodine 125fibrinogen test. In 2 out of 22 patients with a correct protocol deep vein thrombosis was diagnosed. 4 patients showed bleeding complications, in 2 of them heparin had to be stopped. A review of the world literature reveals that heparin prevention has been tested in general surgery in 2253 patients. The incidence of deep vein thrombosis was 8.6% compared to 28% in the controls. In orthopedic surgery only 279 patients are documented, the deep vein thrombosis frequency dropped from 46% to 22.2%. The results are contradictory. Both in urology and gynecology only few patients have been studied, definite conclusions are therefore not possible. The number of fatal pulmonary emboli in about 4000 patients under heparin prevention was 0.2%, in a control group of similar size 0.8%. This difference is statistically significant.