[Ambulatory prevention of thrombosis in traumatology].
There are no guidelines for the use of heparin in the prophylaxis of deep vein thrombosis in outpatients. In a prospective clinical investigation in 1996 and 1997, 1321 outpatients after trauma of the lower extremities were screened by duplex-color-coded-ultrasound in order to detect deep vein thrombosis. There were two separate groups: group A with drug prophylaxis of deep vein thrombosis (n = 723) and group B (n = 598) without. The classification A or B was mainly related to the ability of weight bearing (at least 20 kp) and of ankle mobility (at least 20 degrees). Patients who did not achieve both criteria were classified in group A and were treated with heparin until they attained a higher level of activity (B). Group A showed 30 deep vein thrombosis while group B had no thromboembolic complications. We conclude that outpatients achieving a level of activity close to a physiological situation will show no thromboembolic complications.
Abteilung für Unfall-, Hand- und Wiederherstellungschirurgie, Universität Ulm, Steinhövelstr. 9, 89075 Ulm. ralf.eisele@medizin.uni-ulm.de
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D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007866:Leg / Q000098:blood supply*; D007869:Leg Injuries / Q000150:complications* / Q000628:therapy; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010045:Outpatients; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors; D018615:Ultrasonography, Doppler, Color; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000517:prevention & control*
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006493:Heparin