Case presentation A 64-year-old woman attending the surgical pre-admission clinic is due to be admitted in 2 weeks’ time for an incisional hernia repair. She has a history of atrial fibrillation and is on warfarin. She has also had a recent exacerbation of her chronic obstructive airway disease, for which the general practitioner (GP) has prescribed antibiotics and a 1-week course of prednisolone (30 mg od). The treatment is due to be completed in 2 days, and the anesthetist has already examined her to organize further respiratory investigations. Examination She is a thin woman with a previous midline laparotomy scar.
Her chest is clear, and the heart sounds are normal. Examination of the abdomen confirms a large midline defect in the abdominal wall. The hernia is easily reducible and non-tender. How should anticoagulation be managed prior to surgery? (Answer is posted in the comment…
