IN CERTAIN circumstances it may be desirable to perform some types of vascular surgery while the patient is under the influence of anticoagulant therapy without first neutralizing the anticoagulant effect throughout the body. This situation holds particularly in the surgery of arterial embolism. Advantages appear to be (1) prevention of propagation of the embolus preoperatively and during operative manipulation, (2) prevention of formation of a new thrombus at the freshly sutured site of arteriotomy, (3) obviation of the difficulties and hazards of regional postoperative heparinization and (4) control of all bleeding at the operating table while the patient is under the influence of heparin to prevent formation of wound hematomas which might otherwise develop if heparin therapy were instituted only after operation. Laufman and Heller1 in 1943 showed that if a hematoma does not develop in a wound, anticoagulants will not interfere with wound healing.
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