TITLE

Routine chemoprophylaxis for deep venous thrombosis in Indian patients: Is it really justified?

AUTHOR(S)
Mavalankar, Ashutosh P.; Majmundar, Darshan; Rani, Shubha
PUB. DATE
July 2007
SOURCE
Indian Journal of Orthopaedics;Jul-Sep2007, Vol. 41 Issue 3, p188
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Venous thromboembolism (VTE), which consists of deep vein thrombosis (DVT) and pulmonary embolism, is a potentially fatal disease. According to the Western literature, DVT of lower limb veins is one of the most common complications following total hip and knee arthroplasty and surgeries for lower limb fractures. Very few studies have been published from India on the subject and very little is known about the true incidence of the condition. The issue has acquired greater significance in Indian subjects in recent times as there is a manifold increase in the number of joint replacement surgeries and surgeries for lower limb fractures. There are no clear guidelines regarding the prophylaxis for VTE for Indian patients. Materials and Methods: We carried out a prospective study to determine the incidence of DVT. Present study included 125 patients undergoing total knee and hip joint arthroplasty and surgeries for fractures of the lower limb over a three-year period. All the patients underwent duplex ultrasonography between the seventh and 14th postoperative day. No mechanical or chemical form of DVT prophylaxis was used. Results: Only nine patients (7.2%) showed sonographic evidence of DVT and the majority of them resolved without treatment. There was no case of pulmonary embolism. Conclusion: DVT following total joint arthroplasty and surgery for lower limb fractures in Indian patients is not as common as reported in the Western literature. A high level of suspicion and close clinical monitoring is mandatory, routine chemoprophylaxis is perhaps not justified in every patient undergoing lower limb surgery in our opinion. More trials involving a larger number of patients and at multi centers, in future, would be required to confirm the findings of our study.
ACCESSION #
26069446

 

Related Articles

  • A Comparison of Discharge and Two-Week Duplex Ultrasound Screening Protocols for Deep Venous Thrombosis Detection Following Primary Total Joint Arthroplasty. Dhupar, Scott; Iorio, Richard; Healy, William L.; Dhimitri, Kenneth // Journal of Bone & Joint Surgery, American Volume;Nov2006, Vol. 88-A Issue 11, p2380 

    Background: Thromboembolic disease in the form of deep venous thrombosis and pulmonary embolism is a risk following hip and knee joint replacement. Prophylactic and screening protocols have been employed to prevent thromboembolic disease following lower extremity joint reconstruction. The...

  • VTE, PE, short stay complications after total joint replacements.  // OR Manager;Mar2012, Vol. 28 Issue 3, p1 

    The article offers information on the studies related to the prevention of venous thromboembolism (VTE) for patients having joint replacement. It states that a study revealed that about 1 in 100 patients having knee arthroplasty and 1 in 200 having hip arthroplasty will develop VTE before...

  • Readmissions after fast-track hip and knee arthroplasty. Husted, Henrik; Otte, Kristian Stahl; Kristensen, Billy B.; Ørsnes, Thue; Kehlet, Henrik // Archives of Orthopaedic & Trauma Surgery;Sep2010, Vol. 130 Issue 9, p1185 

    Introduction: With the implementation of fast-track surgery with optimization of both logistical and clinical features, the postoperative convalescence has been reduced as functional milestones have been achieved earlier and consequently length of stay (LOS) in hospital has been reduced....

  • Micro-mobile Foot Compression Device Compared with Pneumatic Compression Device. Dohm, Michael; Williams, Kim M.; Novotny, Tim // Clinical Orthopaedics & Related Research;Jun2011, Vol. 469 Issue 6, p1692 

    Background: A combination mechanical-pharmacologic regimen is an accepted prophylactic treatment against symptomatic venous thromboembolism for patients undergoing total hip and knee arthroplasties. Foot pumps have been recognized as effective mechanical devices. Research suggests pharmacologic...

  • Is the development of clinical DVT guidelines and their required use in primary THA and TKA warranted? Verheyen, Cees C. P. M.; Warwick, David // Orthopaedics Today Europe;Jul/Aug2010, Vol. 13 Issue 4, p7 

    The article presents opposing views on the need to develop guidelines on clinical deep vein thrombosis (DVT) prophylaxis in total hip arthroplasty (THA) and total knee arthroplasty (TKA).

  • A Mobile Compression Device for Thrombosis Prevention in Hip and Knee Arthroplasty. Colwell Jr., Clifford W.; Froimson, Mark I.; Anseth, Scott D.; Giori, Nicholas J.; Hamilton, William G.; Barrack, Robert L.; Buehler, Knute C.; Mont, Michael A.; Padgett, Douglas E.; Pulido, Pamela A.; Barnes, C. Lowery // Journal of Bone & Joint Surgery, American Volume;2/5/2014, Vol. 96 Issue 3, p177 

    Background: Venous thromboembolic events, either deep venous thrombosis or pulmonary embolism, are important complications in patients undergoing knee or hip arthroplasty. The purpose of this study was to evaluate the effectiveness of amobile compression device (ActiveCare+ S.F.T.) with or...

  • Antibiotic and thromboembolic prophylaxis in total hip and knee arthroplasty in Scotland. Pillai, Anand; Atiya, Sami // Quality in Primary Care;2004, Vol. 12 Issue 2, p103 

    Venous thromboembolism and wound infection are serious complications of lower limb arthroplasty. The incidence of these complications in Scotland ranges between 1% and 2%, with considerable regional variation. The Scottish Intercollegiate Guidelines Network (SIGN) was set up to develop evidence-...

  • Review: Extended-duration prophylaxis with heparin prevents deep venous thrombosis in hip or knee replacement. Philbrick, John T. // ACP Journal Club;Jan/Feb2002, Vol. 136 Issue 1, p9 

    Presents an abstract of the study 'Extended-duration Prophylaxis Against Venous Thromboembolism After Total Hip or Knee Replacement: A Meta-analysis of the Randomised Trials,' by J. W. Eikelboom, D. J. Quinlan, J. D. Douketis, published on the July 7, 2001 issue of the 'Lancet' journal. Comment...

  • Heparin prevents deep-vein thrombosis after knee or hip replacement.  // Modern Medicine;Jan96, Vol. 64 Issue 1, p16 

    Reports on the recommendations issued by the American College of Chest Physicians (ACCP) for preventing deep-vein thrombosis (DVT) in patients who undergo total hip- or knee-replacement surgery. Effectiveness of low-molecular-weight heparins; Options for protecting patients.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics