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Surgical-site infections increase the risk of blood clots after colorectal surgery, study finds

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Surgical-site infections increase the risk of blood clots after colorectal surgery, study finds

According to a research conducted by investigators at the Johns Hopkins Hospital, surgical-site infections after abdominal surgery are associated with a higher risk of blood clots than other patients who did not develop postoperative infection. Even if they receive anticoagulants to prevent blood clots, some patients still develop these complications within the first month after surgery, especially those who had a surgical infection.

The study led by Johns Hopkins scientists and published in the Journal of the American College of Surgeons, shows that patients who had surgical-site infection after abdominal surgery have a 4 times greater risk of developing deep vein thrombosis or pulmonary embolism, compared with patients who did not have surgical infection. One possible explanation for this association is that inflammatory proteins involved in the infection cause activation of platelets that lead to blood clots. Blood platelets, or thrombocites, are cells, in fact  cell fragments in the blood, that play a role in hemostasis, that is they stop the bleeding. The study showed that 4% of patients had DVT, but of these 92% had previously received anticoagulants which should prevent blood clots. Study leader Susan L. Gearhart, MD, associate professor of surgery at year the Johns Hopkins University School of Medicine, said that patients with surgical-site infections must be treated with great care in order not to develop DVT.

Almost all surgical patients treated at The Johns Hopkins Hospital receive prophylaxis not only with anticoagulants but also devices to keep blood flowing in the legs during hospitalization. However, this prophylaxis ceases when patients are discharged. Dr. Gearhart pointed out that  medical staff need to be carefully trained about the importance of DVT prophylaxis, and that there have been created automated checklists to remind healthcare professionals about this issue. Deep vein thrombosis and pulmonary embolism are potentially fatal complications that can occur after surgery, especially in orthopedics. These complications can be prevented, this is why there is so much emphasis on anticoagulant prophylaxis. However, it turned out that even if patients do receive prophylaxis, they still developed DVT or pulmonary embolism, especially if they had surgical-site infection.

Investigators arrived at these conclusions after analyzing the records of 615 patients treated at The Johns Hopkins Hospital between 2009 and 2011. Of these, 25 developed DVT even though most (92%) had received prophylaxis with anticoagulants. What investigators also discovered was that 14 of the 25 have had postoperative infection, indicating that there is a link between surgical infection and risk of DVT.