Mechanical and pharmacological methods to prevent venous thromboembolism.
Today, it is possible to define certain risk groups for the development of venous thromboembolism, most studies having been conducted on post-operative venous thromboembolism. Nonetheless, the risk classification is rather inexact, resulting in many patients receiving prophylaxis who would not have gone on to develop the complication. However, the current prophylactic methods are safe and can therefore also be used in the post-operative situation. The dominating pharmacological substances are unfractionated heparin, low-molecular-weight heparins and the pentasaccharide fondaparinux. In some situations (such as elective hip surgery and likely hip fracture surgery, and in many cases where malignant diseases in the abdomen/pelvis have been operated upon), extended prophylaxis for 1 month should be considered.
Bergqvist
David
D
Uppsala University Hospital, Department of Surgical Sciences, SE-75185 Uppsala, Sweden. david.bergqvist@surgsci.uu.se