Overview

When you are preparing for an operation, most of your worries may be about the surgery itself. Meanwhile, your care team is also working to prevent a complication you may not have heard much about: a pulmonary embolism after surgery.
The important point is that many postoperative blood clots can be prevented with appropriate precautions. Early movement, using compression devices as advised, taking prescribed blood thinners on schedule, and maintaining adequate hydration can all help reduce the risk.

Why Does Surgery Increase the Risk of Pulmonary Embolism?

Blood clotting is a natural protective mechanism that helps prevent excessive bleeding. However, after an operation, several changes can increase the tendency for blood clots to form.

Reduced movement can slow blood flow in the legs: The calf muscles help push blood through the deep veins and back towards the heart when you walk. During a long operation and the period of bed rest that may follow, this muscle pump becomes less active. As a result, blood can pool in the leg veins, which can increase the risk of clot formation.
The body becomes more prone to clotting: Surgery triggers the body's natural response to prevent blood loss. Clotting proteins may increase, while the body's natural ability to break down clots may temporarily decrease. This response helps the surgical wound heal but can also increase the risk of unwanted blood clots.
Blood vessels may become irritated: Surgical positioning, tourniquets, and other procedures may occasionally affect blood vessels. Damage or irritation to the inner lining of a vein can contribute to clot formation.

Some types of surgery carry a higher risk than others.

Orthopaedic surgery: Orthopaedic surgery can carry a significant risk of blood clots. Hip and knee replacement, hip fracture repair, and major spine surgery may involve procedures close to large blood vessels, followed by a recovery period during which movement can be limited or painful. This is why blood clot prevention after joint replacement may continue for several weeks after surgery.
Cardiac surgery: Cardiac surgery may involve long operating times, intensive care stays, chest drains, and slower mobility during the early recovery period. These factors can increase the risk of developing blood clots after surgery.
Bariatric surgery: Bariatric surgery can also increase the risk of blood clots. Although many bariatric procedures are performed using minimally invasive techniques, factors such as excess weight and reduced mobility can increase the risk. Some blood clots may also develop after the patient returns home.

How to Prevent Pulmonary Embolism After Surgery?

Preventing blood clots after surgery may involve a combination of mechanical measures, medication, and regular movement.
1.Get Moving Early
Ask your healthcare team when you can safely get out of bed, and start moving as soon as you are cleared to do so. For many procedures, this may be within a few hours of surgery.
You do not need to walk long distances. Walking to a chair, then to the door, and later along the hospital corridor can help activate the calf muscle pump and improve blood circulation. Several short walks may be more manageable than one long walk.
If pain is making it difficult to move, speak to your healthcare team so that your pain can be managed appropriately rather than avoiding movement altogether.

2.Use Your Compression Stockings and Pumps
Graduated compression stockings are tighter around the ankle and gradually become less tight higher up the leg. This helps promote blood flow towards the heart.
Sequential compression devices (SCDs), also called intermittent pneumatic compression devices, are inflatable sleeves that are placed around the legs. They periodically inflate and release pressure, helping improve blood circulation while you are resting in bed.
Use these devices or stockings exactly as instructed by your healthcare team. Do not remove them for longer than necessary unless advised to do so. Tell your nurse or doctor if a stocking rolls down, bunches up, or feels excessively tight or painful. Patients with certain circulation problems may not be suitable for compression stockings, so follow your doctor's advice.

3.Take Your Blood Thinners Exactly as Prescribed

Some patients may be prescribed an anticoagulant, or blood thinner, after surgery. Depending on the situation, this may include heparin, low-molecular-weight heparin, or an oral anticoagulant.
Take the medication exactly as prescribed and do not stop it early simply because you feel well. Do not start aspirin, anti-inflammatory pain medicines, or herbal supplements without first discussing them with your doctor, as some of these may interact with blood thinners.
If your blood thinner is prescribed for several weeks after discharge, continue taking it for the recommended duration. Contact your doctor if you develop unusual bruising, bleeding that does not stop, blood in your urine, or black stools.

4.Do Simple Exercises in Bed

Between walks, simple leg exercises can help maintain circulation. Depending on your condition and your healthcare team's advice, you can point your toes up and down, rotate your ankles, and gently tighten and relax your calf and thigh muscles.
These exercises can be particularly useful on days when pain, medical drains, or other restrictions limit how much you can walk. Follow the exercise instructions provided by your doctor or physiotherapist.

5.Drink Enough Water

Unless your doctor has advised you to restrict fluids, try to drink enough water throughout the day. Adequate hydration is a part of general postoperative recovery.
Some patients, particularly those recovering from certain cardiac or kidney-related conditions, may have specific fluid restrictions. Always follow the fluid recommendations given by your healthcare team. Avoid alcohol during recovery unless your doctor advises otherwise.

Warning Signs to Watch for Blood Clots After Operation

Seek emergency medical help immediately if you develop symptoms that could indicate a pulmonary embolism, whether you are still in the hospital or have already returned home.

Sudden breathlessness: A clot blocking a blood vessel in the lungs can cause sudden or unexplained difficulty breathing. Breathlessness may occur even when you are resting.
Sharp chest pain that worsens when you breathe in: Chest pain associated with PE may become worse with deep breathing or coughing. After surgery, this may sometimes be mistaken for pain related to the operation.
A racing or unusually fast heartbeat: Your heart may beat faster when it is trying to compensate for changes in blood flow or oxygen levels. You may also experience lightheadedness, sweating, or feeling that your heart is pounding.
Coughing blood: A pulmonary embolism can sometimes cause blood to appear when you cough. Even a small amount of blood in the sputum should be medically assessed urgently, particularly after surgery.

Do not wait to see whether these symptoms improve on their own. Seek emergency medical care immediately, and do not drive yourself if you are experiencing severe symptoms.

Why Choose Narayana Health?

Narayana Health cares for patients undergoing a wide range of cardiac, orthopaedic, and bariatric procedures across its network. Blood clot prevention is incorporated into the surgical care pathway and is based on the type of procedure and the patient's individual risk factors.
Depending on the procedure and the patient’s individual risk of clotting and bleeding, the surgical and perioperative care teams develop an appropriate prevention plan. This may include mechanical methods, prescribed anticoagulants, early mobilisation and physiotherapy.
Before discharge, patients and their families are also guided on medication schedules, the appropriate use of compression devices or stockings, mobility, and warning signs that require medical attention.
Since some blood clots can develop after discharge, understanding and following the recommended prevention measures is an important part of recovery.

Conclusion

A pulmonary embolism after surgery is a serious complication, but appropriate preventive measures can help reduce the risk.
It is also important to know the warning signs of PE and seek immediate medical attention if they occur. Blood clot prevention is an important part of postoperative recovery and should be treated as part of your overall surgical care.

FAQs

Q. How long after surgery does the risk of pulmonary embolism remain?
A. The risk can remain for several weeks after surgery, particularly after major operations or if mobility is limited. The exact duration depends on the type of surgery and individual risk factors. Continue the preventive measures and medications recommended by your doctor after discharge.

Q. Can you get a pulmonary embolism even if you are walking after surgery?
A. Yes. Walking reduces the risk of blood clots but does not eliminate it completely. Other factors, such as the type of surgery, previous blood clots, certain medical conditions, and individual clotting risk, can still contribute to PE.

Q. What should you do if you miss a dose of your blood thinner after surgery?
A. Do not automatically take a double dose. The correct action depends on the specific blood thinner you are taking. Check the medication instructions or contact your doctor for advice on the missed dose.

Q. Can I sleep normally after surgery if I am at risk of blood clots?A.
A. Yes. Most patients can sleep normally after surgery. Follow your surgeon’s instructions on sleeping position and use compression devices or stockings as advised. Continue prescribed blood thinners and stay active during waking hours.