Final answer:
Anticoagulant therapy should be discontinued prior to surgery depending on the type of medication, with warfarin generally stopped 5 days before and DOACs 48 hours prior. Coordination with medical providers is key for individualized patient care. Prophylactic antibiotics are given before surgery to reduce infection risks.
Step-by-step explanation:
Patients on anticoagulants who are scheduled for surgery, such as a colectomy for diverticulitis, need to have their anticoagulation therapy discontinued in advance to minimize bleeding risks. The timing of when to discontinue these medications usually depends on the type of anticoagulant the patient is taking. For example, warfarin would typically be stopped approximately 5 days before surgery, and if needed, a bridge therapy with a short-acting agent like low molecular weight heparin may be started and then stopped 24 hours before surgery. However, direct oral anticoagulants (DOACs) would generally be stopped closer to the surgery date, often 48 hours before. The exact timing should be individualized based on the patient's risk of thromboembolism and the specific pharmacokinetics of the anticoagulant. It is crucial to liaise with the patient's cardiologist or primary care provider to ensure the safe cessation and resumption of this therapy. Also, the use of prophylactic antibiotics prior to surgery is essential to minimize the risk of hospital-acquired infections, and they are typically administered 60 minutes before the surgical incision.