The safety of open inguinal herniorraphy in patients on chronic warfarin therapy |
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Authors: | McLemore Elisabeth C Harold Kristi L Cha Stephen S Johnson Daniel J Fowl Richard J |
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Affiliation: | Department of Surgery, Mayo Clinic Arizona, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA. |
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Abstract: | BACKGROUND: The perioperative management of warfarin therapy increases the complexity of open inguinal herniorraphy. METHODS: One thousand consecutive patients undergoing open inguinal herniorraphy were retrospectively reviewed. Patients on warfarin therapy were categorized into 3 groups: continued warfarin (CW), discontinued warfarin (DW), and discontinued warfarin with anticoagulation bridge (DWB). RESULTS: Eighty-eight patients were on chronic warfarin therapy. Warfarin was continued in 19 patients, discontinued in 54, and discontinued with bridge in 15 patients. Operative times were similar between the 3 groups. Length of stay was longest in the discontinued warfarin with bridge group (CW 0.74, DW 0.54, and DWB 3.33 days; P < .0001). There was no significant difference in postoperative complications. The incidence of surgical site hematoma was higher in the continued warfarin and discontinued warfarin with bridge groups (CW 11%, DW 2%, and DWB 13%; P = .14). CONCLUSIONS: Continuation of warfarin may be a safe alternative to discontinuation of warfarin therapy in select patients undergoing open inguinal herniorraphy. |
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Keywords: | Warfarin Open inguinal herniorraphy Perioperative anticoagulation Heparin |
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