Prevention of venous thromboembolism in gynecologic surgery patients.

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.