Semin Thromb Hemost 2020; 46(01): 006-007
DOI: 10.1055/s-0039-1701015
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Perioperative Thrombosis and Hemostasis

Beverley J. Hunt
1  Guy's & St Thomas' NHS Foundation Trust, King's College, London, United Kingdom
Jerrold H. Levy
2  Anesthesiology, Critical Care and Surgery (Cardiothoracic), Duke University Medical Center, Durham, North Carolina
› Author Affiliations
Further Information

Publication History

Publication Date:
04 February 2020 (online)

The life of an expert in thrombosis and hemostasis is never dull: indeed, some of the most challenging episodes in both of our professional lives have involved managing perioperative hemostatic problems. Both of us have offices close to our respective operative theaters and intensive care units, so a quick jog round after a telephone call asking for assistance with a major bleeding problem is often an illuminating way of helping. Certainly, when dealing with multiple trauma cases that require urgent surgery and/or bleeding critically ill patients, the place of the thrombosis and hemostasis expert is flitting among sites or managing other communication efforts to help ensure best practice in managing bleeding. This includes encouraging regular hemostatic monitoring, enabling fast delivery of blood component and/or tranexamic acid.

Historically, surgery has continued for more than two millennia. The first known descriptions come from the sixth century BC when Sushruta, an Indian physician surgeon, performed cosmetic surgery.[1] However, despite this, until recently there was only limited research as to the best ways to manage patients with intraoperative and postoperative bleeding. The description of the risk of venous thromboembolism being greatly increased after surgery is a relatively new phenomenon in comparison, as most of the documentation is from the 1970s onward.

There are many unanswered questions in relation to the best management to prevent and manage perioperative thrombosis and hemostasis. However, we hope this will change quickly with the many current international research programs dedicated to this area and also the establishment of an International Society of Thrombosis and Hemostasis subcommittee that focuses on this area. We are both proud to be founding members of the organizing committee and are thrilled and excited by the overflowing attendance at the meetings we have held, reflecting the interest in this subject.

We have therefore commissioned a set of articles to reflect current best practice in thrombosis and hemostasis in the many different types of surgery now available. We have enjoyed reading and editing them and hope they will encourage more enthusiasm and research in this rapidly-growing area.