Current practice for anticoagulation prophylaxis in inguinal hernia surgery: a questionnaire survey.
OBJECTIVE
The incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) is well documented in patients undergoing surgery involving general anaesthesia. A large number of trials have been conducted establishing the efficacy of prophylactic measures against deep vein thrombosis, yet there remains wide practice variation amongst surgeons regarding the use of anticoagulation measures. The main aims of our study were to survey the use of DVT prophylaxis for inguinal hernia repairs in the UK, and to establish any variations amongst British surgeons in their use of anticoagulation measures for repair of inguinal hernias.


METHODS
We conducted a questionnaire survey amongst surgeons of the Association of Endoscopic Surgeons of Great Britain and Ireland (AESGBI). Two hundred and fifty questionnaires were sent with a response rate of 72%.


RESULTS
Our results have shown wide variation amongst British surgeons in the use of anticoagulation measures. Furthermore, only 10% of the surgeons in the laparoscopic and 14% in the open group risk stratify their patients; 10% of the surgeons do not use any DVT prophylaxis at all.


CONCLUSIONS
Although the incidence of DVT in inguinal hernia repair is very low this is a very commonly performed procedure. Both over and under treatment with thromboprophylaxis can have implications in terms of side effects and costs. One possible way to avoid problems is to risk stratify patients before thromboprophylaxis is instituted.
Department of Surgery, Blackburn Royal Infirmary, Blackburn, United Kindgom. suhail@anwar99.freeserve.co.uk
Suhail
S
Anwar
Patrick
P
Scott
D000925:Anticoagulants / Q000627:therapeutic use*; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D011183:Postoperative Complications / Q000517:prevention & control*; D010818:Practice Patterns, Physicians'; D013514:Surgical Procedures, Operative; D011795:Surveys and Questionnaires; D013923:Thromboembolism / Q000517:prevention & control*; D006113:United Kingdom
D000925:Anticoagulants