Prophylaxis in nonorthopaedic surgery.

Rev Clin Esp

Departamento de Medicina Interna, Hospital Virgen de la Luz, Cuenca, España. Electronic address:

Published: June 2020

AI Article Synopsis

  • Surgery raises the risk of venous thromboembolism (VTE) by 20 times, but effective prophylaxis methods can significantly lower this risk.
  • Prior assessment of patient and surgical risk is essential for choosing the right prophylaxis strategy, with tools like the Caprini and Rogers scales categorizing patients into four risk levels.
  • Prophylaxis approaches vary based on risk: mechanical for low to high risk with heparin contraindications, combined with heparin for very high risk, and specific pharmaceuticals for moderate to high risk, generally continuing until a patient regains full mobility or for extended periods post-surgery in certain cases.

Article Abstract

Surgery increases the risk (by 20-fold) of venous thromboembolism (VTE), but there are prophylaxis methods (mechanical, pharmaceutical or combined) that safely reduce the incidence rate of VTE. The administration of prophylaxis requires a prior assessment of the risks associated with the patient and with the type of surgery. The Caprini and Rogers scales classify patients into four VTE risk categories (very low, low, moderate and high). In pharmacological prophylaxis, the risk of bleeding should also be assessed. At this time, the recommendation is to administer prophylaxis to all patients: mechanical prophylaxis for low, moderate or high risk with contraindications for the administration of heparin; combined with heparin for very high risk; and with drugs such as low-molecular-weight heparin, unfractionated heparin and fondaparinux for moderate to high risk. These measurements should be kept until full ambulation, discharge, or at least seven days (for major oncologic and bariatric surgery, maintain for four weeks).

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http://dx.doi.org/10.1016/j.rce.2020.04.017DOI Listing

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