This year thousands of people will die from postoperative venous thromboembolism. Ironically, the means of preventing such deaths may have been available for years. Recent experience suggests that low doses of subcutaneously administered heparin sodium can safely eliminate postoperative thrombosis and pulmonary embolism.
A relatively new technique, the 125I-fibrinogen scan, has demonstrated an incredible frequency of postoperative venous thrombosis. From 20% to 30% of all surgical patients, 40% to 50% of elderly surgical patients, and more than 50% of patients having hip-nailing procedures or prostatectomies develop postoperative venous thrombosis in the legs.1 Unfortunately, we can detect only one half of these blood clots with careful clinical observation. The other half can be recognized with 125I-fibrinogen scanning.2 Both clinically apparent and inapparent venous thromboses can cause embolism.
Sharnoff and DeBlasio3 demonstrated the significance of these thrombotic events when they found that, among 18,000 unselected surgical patients