ABSTRACT
It is impossible to make a surgical incision without any bleeding. Appropriate tissue handling, use of diathermy and dressings will help to ensure haemostasis. All patients on warfarin having major surgery should be switched to heparin preoperatively, and some surgical procedures also warrant the cessation of aspirin and clopidogrel therapy (although this practice varies considerably from surgeon to surgeon). The avoidance of significant haemorrhage not only decreases the risk of postoperative shock but it also reduces wound infection rates and leads to quicker patient convalescence. The ‘cut and run’ surgical approach of cavalier surgeons should be replaced with careful, meticulous attention to haemostasis.
