The potential beneficial effects of fondaparinux in wound healing following major joint surgery

A major goal following major orthopaedic procedures is the prevention of an undesirable thrombus, while at the same time allowing surgical wound healing to proceed in a timely manner. Research has shown that thrombin is an important component of wound healing. Preserving the role of thrombin is essential for this process to proceed normally. Anticoagulants, such as the heparins, have been associated with slower wound healing. The effect may be related to their ability to bind to multiple targets, including thrombin. In contrast, fondaparinux - the first of a new class of antithrombotics - is a pure synthetic selective factor Xa inhibitor, which, at therapeutic doses, allows a minimal amount of thrombin generation to occur. In addition to providing a more effective alternative for venous thrombosis prophylaxis, this agent may also be beneficial in terms of wound healing.