hysterectomy bacilli ,group B Cefoxitin 1- IV streptocooci, 1- IV anaerobes, Cefotatan enterococci Cesarean Same as for Cefazolin 1g IV after section(high risk hysterectomy cord clamped patient) Traumatic wound Staphylococci, group Cefazolin or 1g IV q8h A streptococci, Amipcillin-sulbactam 1.5- IV q 6h clostridia Table VII: Recommendations for preoperative and postoperative anticoagulation in patients taking oral anticoagulants Indications Preoperative Postoperative Acute venous IV heparin thromboembolism No therapy Within 1 mo of surgery Within 3 mo of surgery Recurrent venous No therapy thromboembolism Acute arterial embolism IV heparin (within 30 days) Mechanical heart valve No therapy Nonvalvular atrial No therapy fibrillation Table VIII: Prophylaxis for DVT and pulmonary embolism Patient group Surgery type Prophylaxis Low risk Minor None Low or moderate risk Major every -12, IPC High risk Major SC every-7 o LMWH Highest risk Major SCevery-8/12 or LMWH +IPC GCS: graded compression stockings. IPC: intermittent pneumatic compression. Low risk: age less than 40 years and no risk factors. Moderate risk: major surgery and age less than 40 years minor procedure with risk factors or between 40 and 60 years of age. High risk: major procedure over 40 years, multiple risk factors present, major procedure. Table IX: Estimation of intraoperative fluid loss and guide for replacement Preoperative deficit Maintenance IVF× hr NPO + preexisting deficit related to disease state Maintenance fluids Maintenance IVF× duration of case
1- IV 1- IV Cefoxitin Cefotatan bacilli ,group B streptocooci, anaerobes, enterococci hysterectomy 1g IV after cord clamped Cefazolin Same as for hysterectomy Cesarean section(high risk patient) 1g IV q8h 1.5- IV q 6h Cefazolin or Amipcillin-sulbactam Staphylococci, group A streptococci, clostridia Traumatic wound Table VII: Recommendations for preoperative and postoperative anticoagulation in patients taking oral anticoagulants Postoperative Preoperative Indications IV heparin No therapy Acute venous thromboembolism Within 1 mo of surgery Within 3 mo of surgery No therapy Recurrent venous thromboembolism IV heparin Acute arterial embolism (within 30 days) No therapy Mechanical heart valve No therapy Nonvalvular atrial fibrillation Table VIII: Prophylaxis for DVT and pulmonary embolism Prophylaxis Surgery type Patient group None Minor Low risk every -12, IPC Major Low or moderate risk SC every-7 o LMWH Major High risk SCevery-8/12 or LMWH +IPC Major Highest risk GCS: graded compression stockings. IPC: intermittent pneumatic compression. Low risk: age less than 40 years and no risk factors. Moderate risk: major surgery and age less than 40 years minor procedure with risk factors or between 40 and 60 years of age. High risk: major procedure over 40 years, multiple risk factors present, major procedure. Table IX: Estimation of intraoperative fluid loss and guide for replacement Maintenance IVF× hr NPO + preexisting deficit related to disease state Preoperative deficit Maintenance IVF× duration of case Maintenance fluids