doiSerbia

Haemostatic disorders in orthopedic surgery: Laboratory diagnosis

Dunjić Radica (Institut za medicinsku biohemiju, Klinički centar Srbije, Beograd)
Elezović Ivo (Institut za hematologiju, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Vukašinović Zoran (Medicinski fakultet, Beograd + Institut za ortopedsko-hirurške bolesti 'Banjica', Beograd)

Coagulative disorders may result from a breakdown in the balance between coagulation and fibrinolysis. It is important to assess relative physiological states of coagulation and fibrinolysis related to operation. An ideal outcome in orthopedic surgical procedures is the achievement of adequate haemostasis without excessive bleeding despite transection of numerous blood vessels, a necessary part of any surgical procedure. Meticulous attention to secure intraoperative haemostasis is a surgeon's responsibility. The postoperative haemostatic response to injury must also lead to a hypercoagulable state and thrombosis because it is also accompanied by stasis and vessel injury, fulfilling Virchow's triad. For discussion of prophylaxis and treatment of venous thromboembolic disease and orthopedic surgical bleeding, the reader is referred to other articles. This paper discusses selected conditions leading to postoperative bleeding and thrombosis after orthopedic surgery as well as laboratory diagnosis.

Keywords: orthopaedic surgery, thromboembolic disease, surgical bleeding, laboratory diagnosis