Deep Venous Thrombosis Prophylaxis in Orthopedic Surgery !
-
Venous thromboembolism (VTE, including deep vein thrombosis [DVT] and pulmonary embolism [PE]) in surgical patients undergoing general anesthesia has been extensively studied. The risk of VTE remains high for up to 2 months after noncancer general surgery. Fatal PE rates range from 0.1% to 0.8% for all patients and may be as high as 7% for patients undergoing surgery for fractured hips. A study of patients with pelvic or lower-extremity fracture (N = 3295) by Pan et al found a 2.08% incidence of PE in patients with below-knee DVT and a 3.17% incidence in patients with above-knee DVT. In many patients who undergo foot and ankle surgery, DVT may develop without clinically apparent symptoms or signs. Many different forms of therapy have been evaluated in this group. Studies of pneumatic compression in cardiac surgery and neurosurgical patients have shown a distinct improvement in the incidence of DVT without the added risk of bleeding. However, the effect is less impressive in higher-risk patients, and compliance can be difficult.
-
@atharva Many pharmacologic agents are currently available to prevent thrombosis. Agents that retard or inhibit the process belong under the general heading of anticoagulants. Agents that prevent the growth or formation of thrombi are properly termed antithrombotics and include anticoagulants and antiplatelet drugs, whereas thrombolytic drugs lyse existing thrombi. There is some evidence to suggest that statins have the potential to reduce recurrent events in patients with VTE. For the importance of prevention, see Hull and Pineo's 1998 study.