Thrombophlebitis perioperative prophylaxis

Bleeding and thrombosis are major causes of morbidity and mortality in patients with chronic myeloproliferative disorders. We retrospectively evaluated 101 consecutive patients affected by primary thrombocytosis (46 male, 55 female, aged 18-84 years; mean +/- SD 61 +/- 15) followed for a period ranging from 6 months up to 10 years (median 5 years) at our hematological unit. At the time of diagnosis 48 patients were asymptomatic; 26 had clinical evidence of atherothrombosis (cerebral ischemic attacks, ischemic heart disease, peripheral occlusive arterial disease), ten had venous thrombosis, four experienced major hemorrhages, 23 presented microvascular ischemic manifestations namely erythromelalgia, paresthesias, acrocyanosis and dizziness...

Perioperative anticoagulant prophylaxis for postoperative venous thromboembolism (VTE) in neurosurgical patients has not gained wide acceptance due to the fear of intracranial bleeding. Physical methods give a worthwhile reduction of postoperative VTE but there still remains a substantial residual incidence. In other clinical indications, low molecular weight heparins have proven to be effective for prophylaxis of VTE when administered postoperatively, with the advantage of no bleeding enhancement during surgery...

PURPOSE: Our experience with inferior vena cava (IVC) filter placement to prevent pulmonary emboli (PE) in cancer patients with deep vein thromboses (DVT) was reviewed to identify indications, patient characteristics, complications, and long-term outcome. METHODS: Charts of 182 patients with cancer were retrospectively analyzed. All patients had received an IVC filter in our institution between January 1980 and April 1992. RESULTS: Of 182 patients, 103 were men and 79 were women...

No abstract text is available yet for this article.

Thromboprophylaxis to surgical patients is generally accepted, and used in the perioperative period by many surgeons as effective means of reducing postoperative thromboembolic complications. Often the prophylaxis is stopped at the time of mobilization or discharge of the patient, although late thromboembolic complications after cessation of the postoperative prophylaxis are known to occur up to 7 weeks after surgery. By scrutinizing thromboprophylactic studies performed in general surgery during the last 20 years, we found the incidence of late thromboembolic complications reported to be about 1% when clinical diagnostics was applied...

Venous thromboembolism is an important cause of morbidity and mortality in hospitalized patients, causing 100,000 to 200,000 deaths per year in the United States. Patients undergoing surgery are at the highest risk of venous thromboembolism. The magnitude of this risk in a patient depends on the surgical procedure performed and the presence of other risk factors that predispose to venous thromboembolism. The clinical diagnosis of both deep vein thrombosis and pulmonary embolism is notoriously inaccurate. Furthermore, two thirds of all fatal pulmonary emboli cause death within 30 minutes of the embolic episode, leaving little time for diagnostic work-up and effective treatment...

The influence of external sequential compression devices (SCD) on the development of postoperative thromboembolic events was studied in 1,300 consecutive men undergoing radical retropubic prostatectomy. Of the 784 men whose perioperative management did not involve the SCD, in 9 (1.1%) thromboembolic complications developed: 7 (0.9%) pulmonary emboli (PE), and 2 (0.3%) deep venous thrombosis (DVT). In the 516 patients with SCD prophylaxis there were 12 (2.3%) thromboembolic complications: 9 (1.7%) PE, and 3 (0...

Despite antithrombotic prophylaxis, deep vein thrombosis (DVT) remains a frequent complication following major hip surgery. Most of the postoperative DVTs are asymptomatic but may result in fatal pulmonary embolism. Thus, detection of these events remains a clinical challenge. The present study evaluated prospectively the clinical usefulness of a systematic screening for proximal DVT in 173 consecutive patients undergoing major hip surgery and given systematic antithrombotic prophylaxis. On the 12th postoperative day, real-time B-mode ultrasonography of lower limbs veins detected 12 patients (7%) with proximal DVT...

Venous thromboembolism is a life threatening, but preventable complication of major surgery. Many neurosurgical patients are at high risk of developing thromboembolic disease. A postal survey was undertaken of 44 UK neurosurgical centres to assess the use of physical and pharmacological methods of prophylaxis against thromboembolism. Thirty-five replies were received from 31 centres. Seventy-seven per cent of units used antiembolism stockings (TEDs) for elective surgery and 37% for emergency surgery; in approximately two-thirds of these units TEDs constituted the sole method of prophylaxis used during both elective and emergency surgery...

Deep vein thrombosis (DVT) is a common condition. Most cases arise as complications during the perioperative period. This can largely be prevented by adequate prophylaxis, principally using low-dose subcutaneous heparin. Only a minority of DVTs produce serious complications, but it is not currently possible to predict the clinical behaviour of any DVT, once formed. For this reason, any identified DVT should be vigorously treated. The mainstay of treatment remains systemic anticoagulation with heparin and then warfarin...

Perioperative low dose heparin was administered to 24 patients who were compared with 19 control patients undergoing peripheral vascular surgical procedures. This prophylactic measure was ineffective in reducing the incidence of subclinical, postoperative deep venous thrombosis, as indicated by iodine-125 fibrinogen scanning. The data suggest that patients undergoing vascular surgery will not benefit from the routine application of this prophylactic regimen.

Postoperative venous thromboembolic complications are a major problem for the gynecologic oncologist. External pneumatic calf compression (EPC), when applied intraoperatively and left on the patient's legs for 5 days postoperatively, has been previously demonstrated to significantly reduce the incidence of venous thromboembolic complications in patients undergoing surgery for pelvic malignancies. The purpose of this study is to evaluate whether a short perioperative course of EPC is also effective in preventing venous thromboembolic complications...

In a randomized, prospective trial of 100 patients, we have studied the safety and efficacy of warfarin sodium in comparison with that of dextran 40 in the prevention of venous thrombosis in patients at high risk for deep vein thrombosis after elective total hip or knee replacement. Warfarin was given in a new two-step regimen designed to avoid bleeding complications while still preventing venous thrombosis. A low dose of warfarin was started ten to 14 days preoperatively, and the prothrombin time was regulated to between 1...

Physical methods of prophylaxis against deep vein thrombosis aim to counteract the stasis of venous blood flow that occurs during immobilisation. Prospective randomized studies have documented that perioperative electrical calf stimulation, intermittent pneumatic compression, and graduated compression stockings effectively reduce the frequency of post-operative deep-vein thromboses. However, up to date it has not been proved that they also reduce the incidence of fatal pulmonary embolism, and so these physical methods represent no valid alternative to the pharmacological methods of prophylaxis against thromboembolic events...

Thromboembolic complications are one of the most common complications in patients undergoing major surgery or conservative treatment in cast. The incidence of thromboembolic complications is the highest in orthopedic and trauma surgery. Stasis in the deep veins of the lower extremity, intimal damage and disorders in blood coagulation are important factors in the pathogenesis of deep vein thrombosis. The most important predisposing risk factors are age, previous thrombosis, varices and the combination of oral contraceptives and smoking...

Venous thromboembolism is a frequent major complication in patients with gynecologic cancer. Risk factors include being elderly and nonwhite, having an advanced stage of malignancy, a past history of deep venous thrombosis, previous venous disease as evidenced by lower extremity edema, venous stasis changes, or varicose veins. Patients who have had pelvic radiation therapy, or who are more than ten percent over their ideal body weight are also at increased risk. Thromboembolism in gyn cancer patients most often occurs in the perioperative period...

Death from venous thromboembolism occurs in the perioperative period at a rate varying between 0.1% and 7.0%. The risk factors and methods of prophylaxis are reviewed and current recommendations presented.

A total of 361 patients undergoing a variety of major neurosurgical procedures were entered into a prospective surveillance program using duplex ultrasound scanning for detection of perioperative deep venous thrombosis (DVT). All patients had duplex scans of the major veins of both legs preoperatively, on the third and seventh postoperative days, and at weekly intervals thereafter if hospitalized. All patients received elastic stocking and intermittent mechanical calf compression. Perioperative DVT was diagnosed by duplex scan in 17 cases (4...

We compared combined B-mode/Doppler (duplex ultrasonic scanning and venography in routine preoperative and postoperative screening for major proximal deep vein thrombosis in 78 patients undergoing total hip or knee arthroplasty. Of 309 extremity examinations, duplex scanning had an overall sensitivity of 85.7% (12/14) and a specificity of 97.3% (287/295). The preoperative prevalence and postoperative incidence of major deep vein thrombosis were 2.5% and 14.1% of patients, respectively, despite intensive mechanical and pharmacologic prophylaxis...

As patient advocates, perioperative nurses are vital to the safety and protection of the surgical patient. They are responsible for providing a safe environment and efficient and economical nursing care. Using the treatment options available, they can optimize the patient's surgical experience and postoperative recovery. OR nurses and managers can potentially prevent extended hospital stays and expense for patients by requiring pneumatic compression stockings and anticoagulants as the standard of care in their operating rooms...