Assessment of the Risk and the Prophylaxis of Venous Thromboembolism in Surgical Patients

This review article first deals with risk factors for developing postoperative venous thromboembolism. The various pharmacological prophylactic methods available today are summarized with focus on dominating method low molecular weight heparin and the two new ones, the Xa inhibitor fondaparinux and the IIa inhibitor ximelagatran, both approved in orthopaedic surgery. The optimal timing to start prophylaxis is between 2 hours before and 10 hours after surgery. Evidence is accumulating that some in risk groups prolonged prophylaxis is indicated, ie. elective hip surgery, probably hip fracture surgery and probably also patients operated on for abdominal/pelvic cancer.