title: Thromboprophylaxis in elective foot and ankle patients--current practice in the United Kingdom.
abstract: BACKGROUND
  The incidence of venous thromboembolism (VTE) is unknown in elective foot and ankle surgery. The National Institute for Health and Clinical Excellence (NICE) recently published guidelines on reducing the risk of venous thromboembolism in surgical patients. This includes patients undergoing elective foot and ankle surgery.
  
  
  METHODS
  In March 2010 we surveyed the current practice in VTE prophylaxis in elective foot and ankle surgery amongst members of the British Orthopaedic Foot and Ankle Society (BOFAS).
  
  
  RESULTS
  The response rate was 84 (53%). The total number of elective foot and ankle operations performed by the surveyed group was 33,500 per annum. The estimated incidence of DVT, PE and fatal PE was 0.6%, 0.1% and 0.02%. In our study the number of patients needed to treat to prevent a single fatal PE is 10,000 although this figure is open to important bias.
  
  
  CONCLUSIONS
  We question the applicability of the NICE guidelines to patients undergoing elective foot and ankle surgery. We consider that this data justifies the prospective study of the incidence of VTE in patients undergoing elective foot and ankle surgery, without the use of chemical thromboprophylaxis.
authors.affiliation: Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Cambridge CB2 2QQ, United Kingdom. pauldhamilton@gmail.com
authors.forename: P D
authors.initials: PD
authors.lastname: Hamilton
authors.forename: K
authors.initials: K
authors.lastname: Hariharan
authors.forename: A H N
authors.initials: AH
authors.lastname: Robinson
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D017558:Elective Surgical Procedures; D005528:Foot / Q000601:surgery*; D019983:Guideline Adherence; D006801:Humans; D019637:Orthopedic Procedures; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000517:prevention & control; D011795:Surveys and Questionnaires; D006113:United Kingdom; D020246:Venous Thrombosis / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants