Clarke-Pearson DL.
Preventions of venous thromboembolism in gynaecologic surgery patients.
Curr Opin Obstet Gynecol 1993 Feb;5(1):73-9

Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710.

To reduce the morbidity and mortality of postoperative deep vein thrombosis and
pulmonary embolism, effective prophylactic methods must be used. An assessment of
the individual patient's risk is essential in deciding the most appropriate method.
In general, women over 40 years of age and all women with other risk factors
benefit from some form of prophylaxis. For patients with benign gynecologic
conditions, low-dose heparin (every 12 hours) and perioperative intermittent
pneumatic calf compression have been shown to be of benefit. Patients at higher
risk, such as gynecologic oncology patients, should receive more intense
prophylaxis with either low-dose heparin (every 8 hours) or prolonged (5 days)
intermittent pneumatic calf compression. Of the two methods, the latter has no
significant complications and is therefore our method of choice.