Warfarin skin necrosis occurs within the first 2 to 3 days after starting warfarin therapy because

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Protein C has a 6-hour half-life,and so it rapidly decreases when warfarin therapy is begun,along with factor VII (both are vitamin K-dependent proteins).Full anticoagulation with warfarin is not obtained until factors X and prothrombin are decreased to less than 50%,requiring 4 to 7 days based on their half-lives.Because protein C is important in controlling clot formation,its decrease actually puts the patient in a prethrombotic state until full anticoagulation is obtained.

Warfarin Skin Necrosis Occurs Within the First 2 to 3