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Journal of Hand Surgery (British and European Volume)
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Articles

Stopping Warfarin Therapy is Unnecessary for Hand Surgery

D. L. WALLACE, M. D. LATIMER and H. J. C. R. BELCHER

From the Department of Plastic Surgery, The Queen Victoria Hospital, East Grinstead, West Sussex, UK

Correspondence: Mr H.J.C.R. Belcher, Department of Plastic Surgery, The Queen Victoria Hospital, Holtye Road, East Grinstead, West Sussex, RH19 3DZ, UK. Tel.: +44-1342-414236; fax: +44-1342-414121; E-mail: hjcrb{at}pncl.co.uk

Interruption of appropriate therapeutic warfarin therapy imposes a risk of morbidity and mortality on the patient. Strategies to reduce the risks of interruption impose relatively large costs in terms of prolonged hospital stay, medication and coagulation monitoring. We report a series of 47 consecutive surgical episodes on the hands of 39 patients without interruption of therapeutic warfarin anticoagulation and with an INR of between 1.3 and 2.9. There was no difficulty with intraoperative haemostasis. Two patients had minor bleeding-related complications with no long-term sequelae. The authors conclude that interruption to warfarin therapy is unnecessary if the INR is less than 3.0 and therefore inappropriate for therapeutically anticoagulated patients undergoing hand surgery.

Key Words: warfarin • hand surgery • anticoagulants

Journal of Hand Surgery (British and European Volume), Vol. 29, No. 3, 201-203 (2004)
DOI: 10.1016/J.JHSB.2003.12.008
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