[Stationary thromboprophylaxis in casualty surgery. Relevance of postoperative mobility and preexisting risk factors].
The presented thromboprophylactic concept includes weight bearing and ankle motion as well as breathing therapy and drug prophylaxis (antiphlogistics, analgesic drugs, heparin). Routinely performed ultrasound screening of the deep veins (legs and pelvis) before release showed a low DVT incidence of 2.5% in a prospective clinical observation of 841 inpatients. Obesity, venous insufficiency, and a history of previous thromboembolic events were associated with a significantly increased risk of thrombosis (relative risk 4.1, 4,9, and 5.8, respectively) The duration of immobilization also had a relevant influence indicating that early postoperative physiotherapy in traumatology and orthopedic surgery has a widely underestimated thromboprophylactic effect.
Abteilung für Unfallchirurgie, Hand- und Wiederherstellungschirurgie, Universität Ulm. ralf.eisele@medizin.uni-ulm.de
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Eisele
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Maier
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Kinzl
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Gude
D000293:Adolescent; D000328:Adult; D000368:Aged; D015984:Causality; D015897:Comorbidity; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000706:statistics & numerical data*; D011182:Postoperative Care / Q000379:methods / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013927:Thrombosis / Q000453:epidemiology* / Q000517:prevention & control*; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000534:rehabilitation / Q000601:surgery*
D005343:Fibrinolytic Agents