Plasma cross-linked fibrin degradation products fraction D in patients undergoing elective abdominal surgery.

In 18 patients undergoing major abdominal surgery we measured the plasma D-dimer concentration (EIA d-dimer kit) preoperatively, postoperatively, and on postoperative day 1, 3, 4, 5, and 6. The patients received thromboembolic prophylaxis with low-molecular weight heparin. All patients were screened with the 125I-fibrinogen uptake test. Preoperatively, the median plasma D-dimer concentration was 500 ng/ml (200-3200 ng/ml) rising to 1800 ng/ml (500-4600 ng/ml) (p less than 0.05) immediately postoperatively. The plasma D-dimer level increased further during the following days to a maximum of 4800 ng/ml (1600-8600 ng/ml) on the 6th postoperative day (p less than 0.01). One patient developed deep-venous thrombosis. The plasma D-dimer concentration of this patients was within the range of the other patients. In conclusion, the EIA D-dimer test does not seem to be a potential screening procedure for postoperative thrombosis.