The Rate of Bleeding Complications After Pharmacologic Deep Venous Thrombosis Prophylaxis

Major bleeding complications from pharmacologic deep venous thrombosis (DVT) prophylaxis are infrequent. Systematic review of the MEDLINE database from 1965 to August 2005, using the terms DVT, prophylaxis, general surgery, and heparin. Randomized controlled trials evaluating pharmacologic DVT prophylaxis in patients undergoing general surgery. Eight complication categories: injection site bruising, wound hematoma, drain site bleeding, hematuria, gastrointestinal tract bleeding, retroperitoneal bleeding, discontinuation of prophylaxis, and subsequent operation. Fifty-two randomized controlled trials studied DVT prophylaxis; 33 randomized controlled trials with 33813 patients undergoing general surgery evaluated pharmacologic prophylaxis and quantified bleeding complications. Of the minor complications, injection site bruising (6.9%), wound hematoma (5.7%), drain site bleeding (2.0%), and hematuria (1.6%) were most common. Major bleeding complications, such as gastrointestinal tract (0.2%) or retroperitoneal (