The Risks Of Bleeding After An Operation
Injury and trauma can cause bleeding after surgery, which can also manifest itself in the form of blood clots. The different types of blood vessels carry oxygen and nutrients to the tissues. When the blood vessels become damaged, bleeding can occur inside or outside them.
Hemostasis is the process that causes the blood to stop in damaged blood vessels. The necessary factors for a blood clot to form include:
- Platelets. Platelets are very small cells that the bone marrow produces. The normal platelet count is between 150,000 and 400,000.
- Coagulation factors. These factors are found in the blood and are primarily produced in the liver.
Surgery increases the risk of venous and arterial thromboembolism. Experts also know that the temporary discontinuation of antithrombotic drugs creates a higher risk of thrombosis and embolism.
The risk of bleeding after surgery induced by oral anticoagulants is usually low. However, it is high during and after surgery, all depending on the surgical procedure.
Risk factors for bleeding after surgery
A risk assessment for a surgical procedure is necessary for these patients. For this reason, the type of antithrombotic treatment that the doctor chooses will depend on the patient’s condition.
Physicians must therefore assess both the thrombotic and hemorrhagic risks of the surgical procedure. The thrombotic risk of the surgical procedure is important due to the increased risk of thrombosis when doctors discontinue treatment with anticoagulant / antithrombotic drugs.
In these cases, doctors may choose to continue or discontinue treatment with anticoagulants. If they choose to discontinue it, they should prescribe heparin and then restart treatment with oral anticoagulants. This is due, most of all, to immobility after surgery, but also to the prothrombotic effect of the surgery itself.
Bleeding after surgery
Major haemorrhages are severe haemorrhages that require a transfusion of at least two units. It can also be bleeding in the brain, chest cavity or stomach.
When faced with a complication related to bleeding, the treatment chosen by the doctor will depend on the degree and location of the bleeding. The levels of anticoagulation also play an important role. Fatal or life-threatening bleeding is also considered major.
The likelihood of bleeding will also determine the resumption of treatment with antithrombotic medication after surgery, as the resumption of anticoagulants in cases of high risk of bleeding will vary.
If the discontinuation of anticoagulant medication continues for more than a day, the medical professional may need to consider giving heparin.
Resumption of treatment with anticoagulants after surgery
Treatment with anticoagulant medication should be resumed two to three days after surgery. However, you should always talk to your doctor.
You should start with low doses, which means those used in prophylaxis, two to three days after surgery. You should start therapeutic dosages after 48-72 hours, and only if you do not suffer from persistent bleeding after surgery.
Most patients treated with both warfarin and acenocoumarol can resume anticoagulation therapy in the evening after surgery, as long as they do not suffer from bleeding complications.
However, the therapeutic effect will not begin until four to five days after starting anticoagulant therapy. One of the primary goals of the patient who has undergone anticoagulation is to restore his antithrombotic state as soon as possible.
Medical professionals should consider adequate hemostasis after surgery and the risk of bleeding associated with the procedure.
Generally, most bleeding is resolved after surgery within the first 24 hours. However, this is not always the case, which is why anticoagulation should not be started until hemostasis returns to normal.
