The safety of open inguinal herniorraphy in patients on chronic warfarin therapy

Elisabeth C. McLemore, Kristi L. Harold, Stephen S. Cha, Daniel J. Johnson, Richard J. Fowl

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Background: The perioperative management of warfarin therapy increases the complexity of open inguinal herniorraphy. Methods: One thousand consecutive patients undergoing open inguinal herniorraphy were retrospectively reviewed. Patients on warfarin therapy were categorized into 3 groups: continued warfarin (CW), discontinued warfarin (DW), and discontinued warfarin with anticoagulation bridge (DWB). Results: Eighty-eight patients were on chronic warfarin therapy. Warfarin was continued in 19 patients, discontinued in 54, and discontinued with bridge in 15 patients. Operative times were similar between the 3 groups. Length of stay was longest in the discontinued warfarin with bridge group (CW 0.74, DW 0.54, and DWB 3.33 days; P < .0001). There was no significant difference in postoperative complications. The incidence of surgical site hematoma was higher in the continued warfarin and discontinued warfarin with bridge groups (CW 11%, DW 2%, and DWB 13%; P = .14). Conclusions: Continuation of warfarin may be a safe alternative to discontinuation of warfarin therapy in select patients undergoing open inguinal herniorraphy.

Original languageEnglish (US)
Pages (from-to)860-864
Number of pages5
JournalAmerican journal of surgery
Issue number6
StatePublished - Dec 2006


  • Heparin
  • Open inguinal herniorraphy
  • Perioperative anticoagulation
  • Warfarin

ASJC Scopus subject areas

  • Surgery


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