Blood loss associated with anticoagulation in patients with replanted digits

The incidence of blood loss and blood transfusion in patients receiving one anticoagulant in addition to aspirin (n = 40) was compared with that in patients receiving two or more anticoagulants in addition to aspirin (n = 15). Multiple-agent therapy produced a greater drop in the hematocrit than single-agent therapy (15% compared with 6%). Only 2% of the patients receiving a single agent had transfusions, as compared with 53% of the patients receiving multiple agents. We conclude that administration of multiple anticoagulants greatly increases the incidence of blood loss and blood transfusion as compared with the administration of a single agent plus aspirin. The importance of salvaging a replanted digit or digits must be weighed against the risks of a blood transfusion.