title: Can deep vein thrombosis be predicted after varicose vein operation in women in rural areas?
abstract: BACKGROUND
  Chronic venous disease is a group of symptoms caused by functional and structural defects of the venous vessels. One of the most common aspects of this disease is the occurrence of varicose veins. There are many ways of prevention and treatment of varicose veins, but in Poland the leading one is still surgery. As in every medical procedure there is the possibility of some complications. One of them is deep vein thrombosis (DVT). The diagnosis of DVT can be difficult, especially when access to a specialist is limited, such as in case of rural patients. The aim of the study. The aim of the study was estimation of the influence of LMWH primary prophylaxis on the formation of postoperative DVT, as well as sensitivity and specificity of clinical examination and D-dimer value in diagnosis of postoperative DVT in women.
  
  
  METHODS
  The study was conducted in a group of 93 women operated on in the Department of General, Vascular Surgery and Angiology at the Karol Marcinkowski University of Medical Sciences in Poznań, Poland. The patients had undergone a varicose vein operation and were randomly divided into two groups: A - 48 women receiving LMWH during two days of the perioperative period, B - 45 women receiving LMWH during seven days of the perioperative period.
  
  
  RESULTS
  There was no significant difference in the postoperative DVT complications in both groups. The value of D-dimer > 0.987 mcg/ml and swelling > 1.5 cm of shin (in comparison to the preoperative period) plays a significant role in diagnosis of DVT.
  
  
  CONCLUSIONS
  The extended primary prophylaxis with LMWH does not affect the amount or quality of thrombotic complications after varicose vein operation. If the DVT occurs, the evaluation of the D - dimer and careful clinical examination can be a useful method for its diagnosis.
authors.affiliation: Department of General, Vascular Surgery and Angiology University of Medical Sciences, Poznań, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Warot
authors.affiliation: Department of General, Vascular Surgery and Angiology University of Medical Sciences, Poznań, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Synowiec
authors.affiliation: Individual Medical Practice, Poznań, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Wencel-Warot
authors.affiliation: Department of General, Vascular Surgery and Angiology University of Medical Sciences, Poznań, Poland.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Daroszewski
authors.affiliation: Department for Health Problems of Ageing, Institute of Rural Health, Lublin, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Bojar
authors.affiliation: Department of General, Vascular Surgery and Angiology University of Medical Sciences, Poznań, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Micker
authors.affiliation: Department of General, Vascular Surgery and Angiology University of Medical Sciences, Poznań, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Chęciński
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D011044:Poland; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors; D012424:Rural Population; D014648:Varicose Veins / Q000601:surgery* / Q000628:therapy; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products; D006495:Heparin, Low-Molecular-Weight; C036309:fibrin fragment D