[Coagulation-physiological studies on the prevention of thromboembolism with dextran 60. I. The effect on platelet...

Platelet aggregation, spreading capacity, adhesiveness (methods according to BREDDIN) have been investigated in 3 groups of 20 patients each after gynecological surgery. Group A (control group) got only 4-hydroxycumarin (Sintrom), group B--in addition to that--intraoperative 500 ml Dextran 60 (Macrodex 6%), group C 500 ml Dextran 60 as well intraoperative as on the 1., 2., 4., 7. and 10. day after surgery. The present data show that depending on the duration of Dextran application, platelet spreading capacity and adhesiveness are inhibited differently as to duration and extent. There was, above all, a reduction and with that a normalisation of the postoperatively increased spontaneous platelet aggregation. It is possible to influence the phase of early postoperative embolism in a favorable way by applicating Dextran already intraoperatively. After that one can use further infusions of Dextran, a prophylaxis by Cumarins or other anticoagulants. Giving dextran only once during surgery one can prove this normalisation of the increased platelet aggregation up to 24 hours postoperatively. By further infusions of Dextran 60 on the 1., 2., 4., 7. and 10. postoperative day it is possible to keep the extent of aggregation on a significantly reduced level till the complete mobilisation of the patient and consequently attain a protective effect on a possible development of deep venous thrombosis of the legs.