Continuing out-of-hospital prophylaxis following major orthopaedic surgery: what now?
Post-surgical deep vein thrombosis (DVT) is often underdiagnosed by clinical assessment alone. Subclinical DVT is a major source of pulmonary embolism, which is an important cause of death, particularly following total hip replacement surgery. Results from pathophysiological studies and recently conducted, prospective double-blind venographic studies in Europe and North America suggest that, in patients undergoing total hip replacement surgery, thromboprophylaxis with a low-molecular-weight heparin should be continued for at least 5 weeks post-operatively to minimize this serious complication.
Department of Orthopaedics, Ullevaal University Hospital, Oslo, Norway. oladahl@start.no
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D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D004311:Double-Blind Method; D005060:Europe; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007866:Leg / Q000098:blood supply; D015337:Multicenter Studies as Topic; D009656:North America; D010045:Outpatients; D010690:Phlebography; D011183:Postoperative Complications / Q000517:prevention & control*; D011184:Postoperative Period; D015995:Prevalence; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D012039:Regional Blood Flow; D012307:Risk Factors; D013923:Thromboembolism / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D013925:Thromboplastin / Q000378:metabolism; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D014859:Warfarin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D014859:Warfarin; D013925:Thromboplastin