approximately 12 h prior to surgery. This strategy has recently evolved. A study by Hull using LMWH approxi¬mately 6h after surgery provided significant efficacy over oral anticoagulants without increased risk of bleeding. This strategy reduced the risk of all deep vein thrombosis by 50% and reduced the risk of proximal (above-the-knee) deep vein thrombosis by 72% ( p < 0.001). Other trials indicate that the best effects are achieved when deep vein thrombosis prophylaxis is initiated close to surgery.

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