General Surgery

Venous thromboembolism is a common problem after surgery, particularly in high risk patients such as elderly, those with malignat disease and those with a history of previous thrombosis. The overall incidence of DVT in general surgical patients is estimated to be 25% in untreated patients. This data is based on pooled studies with a total of 4310 patients included. In patients with malignant disease undergoing surgery, the incidence of DVT was even higher at about 29%.
The treatment effect varies upon the regimen used. The most impressive decrease in the incidence of DVT has been shown for low molecular weight heparins. Pooled data from 9346 cases showed a relative risk reduction for DVT of 76% in all treated patients. There is also large evidence for the effectiveness of unfractionated heparin with a relative risk reduction of 8% among 10339 patients.