Surgery and VTD

Surgery, the intervention itself and the limited mobility during the postoperative period, is a risk factor for thrombosis and pulmonary embolism

VTD and surgery are closely related. In Spain, one in every 7 patients who are diagnosed DVT or PE, have undergone surgery in the weeks prior to the diagnosis of the disease.

This is because, basically, the limited mobility that the convalescent person usually has during the postoperative period, slows down the circulation of the blood in the veins and is more prone to cause thrombosis. In addition, in post-surgical patients, there is a tendency of the blood to clot easier, as part of the body’s response to the intervention.

Orthopedic surgery procedures, hip or knee replacement, femur fractures and the like, are the ones that are most frequently accompanied by DVT ( VTE – your choice, again), comprising 30% of the cases followed by cancer (15%), digestive (13%), genitourinary (10%), and brain surgery (less than 10%).

The risk does not only depend on the type of procedure, its duration and the anesthetic, but also on the patient’s condition before surgery. High-risk patients receive daily injections of low molecular weight heparin to prevent thrombosis. Recently, new oral anticoagulants have been used for the same purpose.

Newly operated patients are urged to get out of bed and walk about ASAP to avoid developing VTE.

Patients need to be aware of how important physical activity is, so that they will keep up the good habit of walking once at home to prevent VTE.


In this graph you can see, in real time with RIETE registry data, the risk of VTE (percentage) with different variables related to surgery


The results obtained in these graphs come from a Database (RIETE) whose rights are duly protected by the Intellectual Property Laws in force.

Its use without the express consent of the holders of rights is strictly prohibited.

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My husband is wearing a prosthesis in his knee since 10 days ago. He did not take his anticoagulants and now his leg hurts. Could it be the reason?

If the pain is in the knee, most likely the cause of the pain is related with surgery. However, if the leg under the knee hurts (and gets swollen), most likely the cause is a thrombosis. In this case, what you need to make clear is the cause of the pain. Ask your doctor. Depending on what the diagnosis is, you will need to receive anticoagulants or not.

My father underwent surgery because of a hernia and he didn’t receive heparin. He then died due to a pulmonary embolism. Was it a case of medical negligence?

Not necessarily. As a consequence of a surgical procedure some patients bleed (during the intervention or during the first days) and in others, blood gets thicker and promotes the creation of coagules (thrombi). If we give heparin, we reduce the risk of thrombosis, but we increase the risk of bleeding. For that reason, every case is different. In any case, nobody can know which patients will bleed (with or without heparin) and which will cause a thrombosis (with or without heparin). Decision to prescribe or nor heparin, is based on approximations. Some procedures bleed a lot and create very few thrombosis, some other procedures bleed very little and create many thrombosis, and some other bleed a lot and create many thrombosis.


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