This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Use of enoxaparin results in more haemorrhagic complications after breast surgery than unfractionated heparin. BJS 2008; 95: 834-836.
Published: 18th April 2008
Authors: R. G. Hardy, L. Williams, J. M. Dixon
Background
Low molecular weight heparin (LMWH) is used in preference to unfractionated heparin (UFH) for the prevention of postoperative thromboembolism in many UK surgical units. There are, however, conflicting reports on the relative risk of significant bleeding in surgical patients, and no data exist in the literature for patients undergoing breast surgery.
Method
Data for patients in the Edinburgh Breast Unit with postoperative breast haematoma that needed surgical intervention were analysed for two 12‐month intervals in which either UFH (2001) or LMWH (2005–2006) was used for thromboprophylaxis. Haematoma rates in the 6 months after UFH was reintroduced in 2006–2007 were also determined.
Results
The rate of haematoma requiring surgical intervention was 0·4 per cent (six of 1452 wounds) in patients who had UFH, compared with 1·8 per cent (32 of 1780 wounds) for LMWH. The rate fell to 0·5 per cent (four of 773 wounds) on reinstituting UFH. The relative risk of haematoma was significantly higher with LMWH than with UFH (4·00 (95 per cent confidence interval 1·97 to 8·11); P < 0·001). No significant postoperative thromboembolic complications were recorded.
Conclusion
LMWH thromboprophylaxis was associated with a significant increase in haemorrhagic complications after breast surgery compared with UFH. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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