Thromboprophylaxis in orthopedic surgery.
More than 2 million people undergo major orthopedic surgery each year, and this rate is expected to continue rising as our population ages. Our patients are at particularly high risk for deep vein thrombosis (DVT) and pulmonary embolism. The latest guidelines from the American College of Chest Physicians recommend thromboprophylaxis for high-risk orthopedic surgery patients. Although specific recommendations vary by type of surgery, low-molecular-weight heparin, fondaparinux, warfarin, and sometimes low-dose unfractionated heparin are effective alone or with mechanical prophylaxis. Goals of treatment are to prevent proximal and distal DVT, pulmonary death, chronic pulmonary hypertension, and postthrombotic syndrome.
Colwell
Clifford W
CW
Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, California, USA.
D000767:Anesthesia, Epidural / Q000009:adverse effects; D000775:Anesthesia, Spinal / Q000009:adverse effects; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D001241:Aspirin; D000075202:Contraindications; D005343:Fibrinolytic Agents; D006620:Hip Fractures / Q000601:surgery; D006801:Humans; D019637:Orthopedic Procedures / Q000009:adverse effects*; D010975:Platelet Aggregation Inhibitors; D018570:Risk Assessment; D013923:Thromboembolism / Q000517:prevention & control*; D015912:Thrombolytic Therapy / Q000379:methods*; D020246:Venous Thrombosis / Q000517:prevention & control*
D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin