You asked, and your colleagues answered. Here's how readers are dealing with deep vein thrombosis, a potentially life-threatening complication of hip and knee surgery, abdominoplasty, breast surgery and other cosmetic cases:
Low molecular weight heparins. A study published in the July 1995 issue of the journal Orthopedics says, "Low molecular weight heparins (LMWHs) have been shown to be effective and safe in the prevention of venous thromboembolism in patients undergoing major orthopedic procedures." In comparative studies, the study adds, LMWHs are more effective than adjusted dose heparin or warfarin without increased risk of bleeding.
Patient risk assessment. Ponte Vedra Plastic Surgery in Florida uses a risk factor scale that takes into account such factors as BMI, past history and age to calculate the number of anticoagulant therapy Lovenox doses the patient should get post-operatively, says Kelly Parkes Wilson, RN, surgery center administrator.
Mechanical prophylaxis. As one reader notes, compression stockings worn from admission to discharge or sequential compression devices used during surgery have "been shown to be as effective as pharma without any side effects or risks of bleeding." One facility uses sequential compression devices on all patients undergoing any procedures longer than 1 hour.
For more tips or to weigh in with your own prevention strategies, visit the DVT Protocol discussion thread here.
Got another question for your colleagues? Post it here. Or visit these recently posted threads on air exchanges in the OR and antibiotic intracameral injections for cataract surgery.
David Bernard
