ABSTRACT
This chapter provides guidelines from an Australian and New Zealand working party on the management and prevention of venous thrombo-embolism (VTE), and an international consensus statement. Graduated compression stockings effectively reduce the risk of VTE for most patients immobilized in hospital. Anticoagulation is the primary means to prevent and treat deep vein thrombosis and pulmonary embolism (PE). Prevention requires a balance between reducing the risk of VTE against the risk of bleeding from anticoagulation. Prolonged anticoagulation is usually required to limit the risk of recurrent deep vein thrombosis or PE, although these benefits must be balanced against the dangers from anticoagulation causing significant bleeding. Timing for ceasing anticoagulation before surgery and recommencing it afterwards depends on the drug half-life and VTE risk. Anticoagulation for nonsurgical thrombo-prophylaxis can be extrapolated from the recommendations for surgery. Recommended anticoagulation for general surgery is with unfractionated heparin or low molecular weight heparin.
