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Blood Clot Formation

Foot Pump
TED stockings and foot pumps are placed on the patient before the surgery is begun to keep blood flowing through the legs during surgery, thus reducing the risk of blood clot formation

The human body's bloodstream has a complicated system which constantly adjusts itself to either increase or decrease the tendency to bleed. Activity such as long car rides or sitting on a plane may lead to the formation of blood clots in the legs. Occasionally these clots move from the legs to the lungs or cause an embolism which may, although rarely, lead to death.

Around the time of surgery, the body reacts by increasing the blood's tendency to clot. This may lead to blood clot formation in the legs. A number of techniques are available to decrease this risk. Some of these are classified as mechanical prophylactic techniques. Patients are encouraged to get up and about as quickly as possible after surgery. Tight stockings are also used on the legs, as well as "foot pumps" which are designed to keep the blood moving through the legs.

The use of a chemical means of blood clot prevention is controversial. Warfarin, which has been used as a rat poison for over 100 years, is a common form of blood thinner which can be used. Also, various forms of heparin may be used. There are several newer forms of blood thinners (anticoagulants) that can be used, and aspirin is commonly used. All anticoagulants, or blood thinners, have been shown to decrease the risk of blood clot formation in the legs; however, all of these have been shown to increase the risk of bleeding. Patients with a tendency to have gastric (stomach) bleeding, have experienced catastrophic bleeding into the stomach. Bleeding into the wound has been a severe problem to some patients who are on blood thinners. Bleeding into the wound may result in a "hematoma", a large clot of blood in the wound which may require surgical removal. Large hematomas increase the risk of infection in the wound.

Blood thinners are used sparingly in most cases, and larger doses are given only to patients at high risk, such as those who have had a prior history of blood clot formation or a strong family history of blood clots. Please tell your surgeon if this applies to you. Many surgeons recommend a low dose of aspirin for four to six weeks post surgery.

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