PMID- 18425795
OWN - NLM
STAT- MEDLINE
DCOM- 20080718
LR  - 20081128
IS  - 1365-2168 (Electronic)
IS  - 0007-1323 (Linking)
VI  - 95
IP  - 7
DP  - 2008 Jul
TI  - Use of enoxaparin results in more haemorrhagic complications after breast surgery 
      than unfractionated heparin.
PG  - 834-6
LID - 10.1002/bjs.6203 [doi]
AB  - BACKGROUND: Low molecular weight heparin (LMWH) is used in preference to 
      unfractionated heparin (UFH) for the prevention of postoperative thromboembolism 
      in many UK surgical units. There are, however, conflicting reports on the 
      relative risk of significant bleeding in surgical patients, and no data exist in 
      the literature for patients undergoing breast surgery. METHODS: Data for patients 
      in the Edinburgh Breast Unit with postoperative breast haematoma that needed 
      surgical intervention were analysed for two 12-month intervals in which either 
      UFH (2001) or LMWH (2005-2006) was used for thromboprophylaxis. Haematoma rates 
      in the 6 months after UFH was reintroduced in 2006-2007 were also determined. 
      RESULTS: The rate of haematoma requiring surgical intervention was 0.4 per cent 
      (six of 1452 wounds) in patients who had UFH, compared with 1.8 per cent (32 of 
      1780 wounds) for LMWH. The rate fell to 0.5 per cent (four of 773 wounds) on 
      reinstituting UFH. The relative risk of haematoma was significantly higher with 
      LMWH than with UFH (4.00 (95 per cent confidence interval 1.97 to 8.11); P < 
      0.001). No significant postoperative thromboembolic complications were recorded. 
      CONCLUSION: LMWH thromboprophylaxis was associated with a significant increase in 
      haemorrhagic complications after breast surgery compared with UFH.
CI  - (c) 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, 
      Ltd.
FAU - Hardy, R G
AU  - Hardy RG
AD  - Edinburgh Breast Unit, Western General Hospital, Edinburgh, UK.
FAU - Williams, L
AU  - Williams L
FAU - Dixon, J M
AU  - Dixon JM
LA  - eng
PT  - Journal Article
PL  - England
TA  - Br J Surg
JT  - The British journal of surgery
JID - 0372553
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
SB  - IM
CIN - Br J Surg. 2008 Nov;95(11):1426; author reply 1427. PMID: 18844276
CIN - Br J Surg. 2008 Nov;95(11):1426; author reply 1427. PMID: 18844277
CIN - Br J Surg. 2008 Nov;95(11):1426-7; author reply 1427. PMID: 18844278
MH  - Anticoagulants/*adverse effects
MH  - Breast Diseases/*surgery
MH  - Enoxaparin/*adverse effects
MH  - Female
MH  - Hematoma/*chemically induced
MH  - Humans
MH  - Postoperative Hemorrhage/*chemically induced
MH  - Thromboembolism/prevention & control
EDAT- 2008/04/22 09:00
MHDA- 2008/07/19 09:00
CRDT- 2008/04/22 09:00
PHST- 2008/04/22 09:00 [pubmed]
PHST- 2008/07/19 09:00 [medline]
PHST- 2008/04/22 09:00 [entrez]
AID - 10.1002/bjs.6203 [doi]
PST - ppublish
SO  - Br J Surg. 2008 Jul;95(7):834-6. doi: 10.1002/bjs.6203.