Blood is supposed to clot in a wound to stop bleeding. But sometimes the body’s clotting mechanism overreacts and harmful clotting occurs in the major veins of the legs. This becomes dangerous if the leg clots break off and travels to the lung (pulmonary embolus). It is well-known that this sometimes occurs after major hip or knee surgery.
To prevent this, blood thinners are sometimes prescribed after surgery. But blood thinners will decrease normal desired clotting in the surgical wound and can lead to complications of excess wound drainage and infection. It can also cause life threatening bleeding from a previously silent stomach ulcer or even cause a stroke.
Blood thinners are a double-edged sword; while blood thinners prevent harmful clots, they may cause harmful bleeding complications. The level of reactivity of everyone’s clotting system varies widely, but so far, no reliable methods have been demonstrated to quantify this level of reactivity.
There continues to me enormous disagreement among experts about which level of blood thinning is best after surgery. After years of experience we have developed a protocol that results in a rate of wound infection less than 0.1% and a rate of leg clots of less than 1%.