Low-dose heparin prophylaxis and postoperative wound hematoma.

In a randomized study, 124 patients, undergoing abdominal hysterectomy, were examined for postoperative wound hematoma after receiving low-dose heparin or heparin-dihydroergotamin (DHE) prophylaxis. Different sites of injection were chosen, with or without subcutaneous administration of thrombin at the end of surgery. The postoperative incidence of wound hematoma was not improved by subcutaneous thrombin administration. There was no difference between the two types of prophylaxis. When heparin or heparin/DHE was injected in the upper arm, however, fewer hematomas were found than after injection in the abdominal region. Investigations of the coagulation and fibrinolytic systems showed no difference between the two types of prophylaxis and injection site. The administration of thrombin did not cause intravascular activation of the coagulation system.