Tuesday, 18 August 2015

Warfarin-induced skin necrosis following recommencement of warfarin after perioperative Prothrombinex-VF. MJA May 2015.

This case study discusses the case of a patient who developed warfarin-induced skin necrosis (WISN) – a rare complication induced by a transient paradoxical hypercoagulable state.  This patient had Prothrombinex-VF only (without vitamin K or FFP) for warfarin reversal for an urgent AAA repair, and developed widespread WISN following reintroduction of warfarin therapy post operatively. The author highlights that vitamin K should be administered with Prothrombinex-VF during warfarin reversal as it sustains the reversal effect, may increase the levels of anticoagulants protein C and S, and avoiding potential thrombotic complications.

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