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Prolonged Bleeding After Surgery

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The Coagulation Consult

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Abstract

Abnormal bleeding can occur after any invasive procedure, and it is seen more frequently after emergency surgery than after elective procedures. Ideally, bleeding complications are prevented by a careful medical history before surgery and laboratory investigation when a hemostatic defect can be suspected. When pre- or postoperative bleeding complication occurs, all available information from medical history, drug intake, inspection of the wound, other signs on physical examination, and screening laboratory tests should be taken into account to understand the cause of bleeding and to give adequate hemostatic therapy. There are approximate guidelines when red cells, platelets, plasma, cryoprecipitate, or fibrinogen should be given. The level of evidence is generally low but most of the measures can be physiologically justified.

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Abbreviations

aPTT:

Activated partial thromboplastin time

ASA:

Acetylsalicylic acid

CBC:

Complete blood count

CI:

Confidence interval

DIC:

Disseminated intravascular coagulation

NSAIDs:

Nonsteroid anti-inflammatory agents

PBAC:

Pictorial bleeding assessment chart

PCC:

Prothrombin complex concentrate

PT:

Prothrombin time

rFVIIa:

Recombinant activated factor VIIa

TCT:

Thrombin clotting time

VWD:

von Willebrand disease

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Authors and Affiliations

  1. Department of Medicine, McMaster University and Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada

    Sam Schulman M.D., Ph.D.

  2. Thrombosis Service, HHS-General Hospital, 237 Barton Street East, Hamilton, ON, Canada, L8L 2X2

    Sam Schulman M.D., Ph.D.

Authors
  1. Sam Schulman M.D., Ph.D.
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Correspondence to Sam Schulman M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Hematologic Oncology and Blood Disorders, Cleveland Clinic, Cleveland, Ohio, USA

    Alan Lichtin

  2. Cardiovascular Medicine and Hematology, Cleveland Clinic, Cleveland, Ohio, USA

    John Bartholomew

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Schulman, S. (2014). Prolonged Bleeding After Surgery. In: Lichtin, A., Bartholomew, J. (eds) The Coagulation Consult. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9560-4_10

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  • DOI: https://doi.org/10.1007/978-1-4614-9560-4_10

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  • Publisher Name: Springer, New York, NY

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