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November 1965

Prevention of Wound Hemorrhage and Embolism During Heparin Therapy

Arch Surg. 1965;91(5):817-822. doi:10.1001/archsurg.1965.01320170111018

A CONTINUOUS search is being conducted for safe anticoagulants which will prevent extension of thrombosis and prevent pulmonary embolization. Surgeons are especially plagued with the problem of postoperative embolism. Sodium heparin appears to be the most effective anticoagulant since it is an antithrombic substance and does not interfere with the synthesis of the normal constituents of blood coagulation. Schwartz has shown that heparin is effective in preventing experimental thrombosis induced by direct current coagulation. Bishydroxycoumarin (Dicumeral), on the other hand, is ineffective.1 The clinical results with heparin are more effective than those warfarin (Coumadin) derivatives, and many physicians doubt that bishydroxycoumarin is beneficial in dosages which do not prolong the clotting time.

Fresh bleeding into a recent surgical wound is a problem in the use of heparin. According to Saltzman,2 wound infections are more numerous when heparin is used because of the consistent occurrence of unrecognized hematomas. Postoperative

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