Abstract Postoperative thrombophlebitis and pulmonary embolism have long been problems for the surgeon. Certain patients have a predisposition for these complications and a safe method of prevention would be of immense value. Anticoagulation with coumarins preparations has been well-documented1-3 as effective in preventing postoperative thromboembolic disease, but there are certain disadvantages to this method. Dextran 75 has been shown to be effective in treating thrombophlebitis and also in preventing arterial and venous thromboses under experimental and some clinical conditions.4-9 Certain conditions have long been known to predispose to venous thrombosis and pulmonary embolism. Among these conditions are age above 50, obesity, and visceral cancer, as well as incisional prostatic surgery, hip surgery, prolonged immobilization, and most major abdominal, pelvic, and vascular operations.1-3,10 Anticoagulation is contraindicated in any situation which might give rise to bleeding and in liver disease. Good control is necessary and not always easy to obtain. References 1. Belding, H.: Use of Anticoagulants in the Prevention of Venous Thromboembolic Disease in Postoperative Patients , Arch Surg 90:566-573 ( (April) ) 1965.Crossref 2. Salzman, E.W.; Harris, W.A.; and DeSanctis, R.W.: Anticoagulation for Thromboembolism , New Eng J Med 275:122-131 ( (July 21) ) 1966.Crossref 3. Skinner, D.B., and Salzman, E.W.: Anticoagulant Prophylaxis in Surgical Patients , Surg Gynec Obstet 125:741-746 ( (Oct) ) 1967. 4. Sawyer, R.B.; Moncrief, J.A.; and Canizaro, P.C.: Dextran Therapy in Thrombophlebitis , JAMA 191:740-742 ( (March 1) ) 1965.Crossref 5. Sawyer, R.B., and Moncrief, J.A.: Dextran Specificity in Thrombus Inhibition , Arch Surg 90:562-566 ( (April) ) 1965.Crossref 6. Just-Viera, J.O., and Yeager, G.H.: Protection From Thrombosis in Large Veins , Surg Gynec Obstet 118:354-360 ( (Feb) ) 1964. 7. Just-Viera, J.O.; Staufer, W.B.; and Yeager, G.H.: Antithrombogenic Properties of Dextran , Clin Med 3:31-34 ( (Aug) ) 1966. 8. Bryant, M.R.; Bloom, W.S.; and Brewer, S.: Use of Dextran in Thrombophlebitis: Experimental and Clinical Studies , Amer Surg 32:13-16 ( (Jan) ) 1966. 9. Atik, M.: Dextran 40 and Dextran 70: A Review , Arch Surg 94:664-672 ( (May) ) 1967.Crossref 10. Farmer, D.A., and Southwick, R.H.: Thromboembolic Disease: Discussion of Problem in Surgical Patients With Particular Reference to Fatal Embolus , Angiology 1:291-301 ( (Aug) ) 1950.Crossref 11. Arturson, C., and Wallenius, G.: The Intravascular Persistence of Dextran of Different Molecular Sizes in Normal Humans , Scand J Clin Lab Invest 16:76-80, 1964.Crossref 12. Bloom, W.L., et al: Coating of Vascular Surfaces and Cells: A New Concept in the Prevention of Intravascular Thrombosis , Proc Soc Exp Biol Med 115:384-486 ( (Feb) ) 1964.Crossref 13. Driscoll, A.C., et al: Clinically Unrecognized Myocardial Infarction Following Surgery , New Eng J Med 264:633-639 ( (March 30) ) 1961.Crossref 14. Kelly, J.L.; Campbell, D.A.; and Brandt, R.: The Recognition of Myocardial Infarction in the Early Postoperative Period , Arch Surg 94:673-683 ( (May) ) 1967.Crossref 15. Koekenberg, L.J.L.: Experimental Use of Macrodex as a Prophylaxis Against Post-Operative Thromb-embolism , Bull Soc Int Chir 21:501-512 ( (Sept) -Oct) 1962.
Archives of Surgery – American Medical Association
Published: Jun 1, 1969