Prevention of venous thromboembolism after surgery

Most surgical patients who require hospitalization are at high risk for venous thromboembolism (VTE) and should receive VTE prophylaxis, usually including pharmacologic prophylaxis. Nevertheless, rates of appropriate perioperative thromboprophylaxis remain stubbornly low, though an expansion in quality-improvement efforts has led to widespread hospital implementation of prophylaxis strategies in recent years. This article reviews important principles and recent developments in perioperative VTE prophylaxis, with a focus on key recommendations and changes in the 2008 update of the American College Chest Physicians' (ACCP) evidence-based guidelines on antithrombotic therapy.