Audit of attitudes to and use of postoperative thromboembolic prophylaxis in a regional health authority.
A survey of usage and attitudes to thromboembolic prophylaxis among 46 general surgeons in the Mersey Region found that 87% use either low-dose heparin, graduated compression stockings or both on a regular basis for their major cases. However, there was a wide variation of usage: 9 (19.6%) always used heparin in combination with thromboembolic stockings, 4 (8.7%) always used heparin alone, no surgeon used thromboembolic stockings alone. A total of 18 (39%) used thromboembolic stockings in combination with heparin, one-half of them selectively. A further 24% of surgeons used either low-dose heparin or thromboembolic stockings or both on selected patients. Current literature beliefs concerning the efficacy of low-dose heparin and thromboembolic stockings showed a similar variation, with 13% of surgeons believing that the efficacy of low-dose heparin against postoperative deep vein thrombosis has not been shown, 22% believing that thromboembolic stockings were ineffective against postoperative deep vein thrombosis, and 24% believing that low-dose heparin was of no value as a prophylactic agent against postoperative pulmonary embolism. Published meta-analysis has shown these beliefs to be wrong.
Jones
D R
DR
Countess of Chester Hospital.
D001291:Attitude of Health Personnel; D001458:Bandages; D004739:England; D013502:General Surgery; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control*; D010818:Practice Patterns, Physicians'; D011655:Pulmonary Embolism / Q000517:prevention & control; D011795:Surveys and Questionnaires; D013923:Thromboembolism / Q000517:prevention & control*; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data*
D006493:Heparin