Medication postoperative thrombosis prophylaxis
Particularly in older patients who can no longer be mobilized or in patients who have several risk factors, it makes sense to use drug-based postoperative thrombosis prophylaxis. In this case, drugs are used that inhibit blood coagulation and thus ensure that the blood platelets (thrombocytes) do not stick together and form a thrombus. These anticoagulants are called anticoagulants in medical terminology.
Heparinoids, i.e. drugs that are derived from heparin or imitate the effect of heparin, are used particularly frequently. In humans, heparin is normally produced in the liver and physiologically inhibits blood clotting. If heparinoids, i.e. heparin analogues, are given, the blood is thinned, which is very good as a medicinal postoperative thrombosis prophylaxis.
Acetylsalicylic acid or aspirin can also be used. Especially after heart attacks it is often used as a permanent medication, but as a postoperative thrombosis prophylaxis it is not as suitable as, for example, Factor Xa inhibitors. Factor Xa is important to complete coagulation.
If this factor is now inhibited, coagulation does not take place and the blood remains fluid and does not clump together to form a thrombus. A distinction is made between direct Factor Xa inhibitors (e.g. Xarelto® rivaroxaban, abixaban) and indirect Factor Xa inhibitors, which are the heparin analogues already mentioned (e.g. Danaparoid).
The direct Factor X-a inhibitors are among the new anticoagulants and are now more frequently used in postoperative thrombosis prophylaxis. Over a longer period of time, sometimes also as long-term medication, the derivatives of coumarins (warfarin) or phenprocoumon (marcoumar) can be used. These inhibit vitamin K. Vitamin K is normally responsible for coagulation, i.e. it helps to form a blood clot, which is extremely important in the case of a fresh wound, for example.
If the vitamin K is now inhibited, it can no longer develop its effect and the blood liquefies, which is excellent for postoperative thrombosis prophylaxis, but has a very negative effect on wound healing. This in turn leads to patients who take vitamin K inhibitors bleeding heavily and, above all, for much longer in the event of injury.
