Abstract One hundred five patients over age 40 undergoing various major operations were randomly divided into control and treated groups; all were treated by subcutaneous injection containing either 5,000 international units aqueous heparin sodium or a placebo one hour prior to operation and every 12 hours thereafter for eight days. Deep vein thrombosis (DVT) was detected by daily 125I-fibrinogen injection and leg scanning, and confirmed by ascending phlebography. Both groups were comparably distributed by age, sex, variety of operation, incidence of previous thromboembolism, and myocardial and cerebrovascular disease. Blood loss was not increased in the treated group. Incidence of DVT was 8.6% for the total group, 7.5% in the heparin-treated group (four of 53), and 9.6% in the control group (five of 52), including one control patient with a normal scan who later had a pulmonary embolus. References 1. Coon WW, Willis PW III: Deep venous thrombosis and pulmonary embolism: Prediction, prevention and treatment . Am J Cardiol 4:611-621, 1959.Crossref 2. Sharnoff JG, DeBlasio G: Prevention of fatal postoperative thromboembolism by heparin prophylaxis . Lancet 2:1006-1007, 1970.Crossref 3. Kakkar VV, Nicolaides AN, Field ES, et al: Low doses of heparin in prevention of deep vein thrombosis . Lancet 2:669-671, 1971.Crossref 4. Kakkar VV, Spindler J, Flute PT, et al: Efficacy of low doses of heparin in prevention of deep vein thrombosis after major surgery . Lancet 2:101-106, 1972.Crossref 5. Gordon-Smith IC, LeQuesne LP, Grundy DJ, et al: Controlled trial of two regimens of subcutaneous heparin in prevention of postoperative deep-vein thrombosis . Lancet 1:1133-1135, 1972.Crossref 6. Nicolaides AN, Desai S, Douglas JN, et al: Small doses of subcutaneous sodium heparin in preventing deep venous thrombosis after major surgery . Lancet 2:890-893, 1972.Crossref 7. Lahnbord G, Friman L, Bergstrom K, et al: Effect of low-dose heparin on incidence of postoperative pulmonary embolism detected by photo-scanning . Lancet 1:329-331, 1974.Crossref 8. Macintyre IMC, Vasilescu C, Jones DRB, et al: Heparin versus dextran in the prevention of deep-vein thrombosis: A multi-unit controlled trial . Lancet 2:118-120, 1974. 9. Abernethy EA, Hartsuck JM: Postoperative pulmonary embolism: A prospective study utilizing low-dose heparin . Am J Surg 128:739-742, 1974.Crossref 10. Gallus AS, Hirsh J, Tuttle RJ, et al: Small subcutaneous doses of heparin in prevention of venous thrombosis . N Engl J Med 288:545-551, 1973.Crossref 11. Williams HT: Prevention of postoperative deep-vein thrombosis with perioperative subcutaneous heparin . Lancet 2:950-952, 1971.Crossref 12. McFarlane AS: In vivo behavior of I131-fibrinogen . J Clin Invest 42:346-361, 1963.Crossref 13. Merskey C, Lalezaki P, Johnson AJ: A rapid, simple, sensitive method for measuring fibrinogen split-products in human serum . Proc Soc Exp Biol Med 131:871-875, 1969.Crossref 14. Breen FA, Tullis JL: Ethanol gelation: A rapid screening test for intravascular coagulation . Ann Intern Med 69:1197-1206, 1968.Crossref 15. Niewiarowski S, Gurewich V: Laboratory identification of intravascular coagulation: The serial dilution protamine sulfate test for the detection of fibrin monomer and fibrin degradation products . J Lab Clin Med 77:665-676, 1971. 16. Covey TH, Sherman L: The 125I-labeled fibrinogen test in the diagnosis of postoperative thrombophlebitis . Angiology 25:61-66, 1974.Crossref 17. Sigel B, Ipsen J, Relix WR: The epidemiology of lower extremity deep venous thrombosis in surgical patients . Ann Surg 179:278-290, 1974.Crossref 18. Rogers PH, Marter VJ: Thromboembolic complications of hip fractures . Orthop Clin North Am 5:509-523, 1974. 19. Nicolaides AN, Field ES, Kakkar VV, et al: Prostatectomy and deep-vein thrombosis . Br J Surg 59:487-488, 1972.Crossref 20. Hartsuck JM, Greenfield LJ: Postoperative thromboembolism: A clinical study with pulmonary and 125I-fibrinogen and pulmonary scanning . Arch Surg 107:733-739, 1973.Crossref 21. Salzman EW, Harris WH, DeSanctis RW: Reduction in venous thromboembolism by agents affecting platelet function . N Engl J Med 284:1287-1292, 1971.Crossref 22. Butterfield WJH, Hicks BH, Ambler AR, et al: Effect of aspirin on postoperative venous thrombosis: Report of a steering committee of a trial sponsored by the Medical Research Council . Lancet 2:441-444, 1972. 23. Hickman JA: A study of the metabolism of fibrinogen after surgical operations . Clin Sci 41:141-152, 1971. 24. O'Brien JR, Jamieson S, Etherington M, et al: Platelet function in venous thrombosis and low-dosage heparin . Lancet 1:1302-1305, 1972.Crossref 25. Yin ET, Wessler S, Stoll PJ: Biological properties of the naturally occurring plasma inhibitor to activated factor X . J Biol Chem 246:3703-3711, 1971.
Archives of Surgery – American Medical Association
Published: Aug 1, 1975