**5.1 Prophylaxis for thromboembolisim**

	- 5000 U subcutaneously administered 2 h before surgery.
	- 5000 U subcutaneously administered, q8h or q12h postoperatively.

This regimen is followed until the patient is discharged.

• Low-molecular-weight heparin prophlaxis

Dalteparin: 5000 U subcutaneously administered, q24h (to be initiated on evening of surgery).

Fondaparinux: 2.5 mg, subcutaneously administered, started 6 h after surgery followed by once daily.

Enoxaparin: 40 mg subcutaneously administered, q24 hourly (to be initiated on evening of surgery). 30 mg administered subcutaneously q24h, if creatinine clearance of less than 30 mL/min [5].

• WARFARIN PROPHYLAXIS

1.10 mg by mouth the evening before surgery.

5 mg by mouth the evening of surgery

Adjust dose daily based on an INR of 2 to 3.

Maintain warfarin until discharge.

2.10 mg by mouth the evening of surgery.

No warfarin on postoperative day 1

On postoperative day 2, begin warfarin to adjust INR to 2 to 3

Maintain warfarin until discharge

We recommend the following regimen for prophylaxis post surgery for abdominal trauma:-


Treatment:- Heparin: 5000 U, SC, q12 hourly.

Enoxaparin: 40 mg, SC, started 12 h postoperatively, followed by 40 mg, SC, q24 hourly.

Dalteparin: 5000 IU, SC, started 12 h postoperatively, followed by 5000 IU, SC, q24 hourly

• High-risk surgery including non major surgery with age > 60 yr.; VTE risk factors; major surgery, age > 40 yr., or presence of VTE risk factors

Treatment:-Heparin: 5000 U q8 hourly.

Enoxaparin: 40 mg, SC, started 12 hourly postoperatively, followed by 40 mg, SC, q24 hourly.

*Life Threatening but Preventable and Treatable Medical Complications of Abdominal Trauma DOI: http://dx.doi.org/10.5772/intechopen.106134*

Dalteparin: 2500 IU, SC, 1–2 h preoperatively then 2500 IU, SC, 12 h postoperatively, followed by 5000 IU, SC, q24 hourly

• Very high-risk surgery including major surgery, multiple VTE risk factors present or age >60 years

Treatment: External pneumatic compression with anticoagulant therapy including;- Heparin: 5000 U, SC, q8 hourly.

Enoxaparin: 40 mg, SC, started 12 hours postoperatively, then 40 mg, SC, q24 hourly.

Dalteparin: 5000 IU, SC, started 12 h postoperatively, followed by 5000 IU, SC, q24 hourly [6].
