Thrombosis prophylaxis

A blood clot blocking a blood vessel

Thrombosis prophlaxis is the pre- and post-operative treatment to prevent the formation of blood clots inside a blood vessel, obstructing the flow of blood through the circulatory system. Limiting the flow through a blood vessel will cause hypoxia or tissue death. Blood clots can form in the body post-operative, most commonly in the legs.

Thrombosis prophlaxis is needed to prevent Venous stasis(VS). Venous stasis is a risk factor for forming blood clots in the deep veins of the legs.[1] Venous stasis can occur during the long periods of immobility that accompanies some surgeries. The use of intermittent pneumatic compression is common.[2][3]

Clarence Crafoord is credited with the first use of thrombosis prophylaxix in the 1930s.

Thrombosis prophylaxis is often prescribed for hospitalized patients routinely by a number of means. Pre-operatively some patients receive low-molecular-weight heparin once a day. Additional risk factors such as obesity, disease, malignancies, long surgeries, and immobility may influence the prescribed dosage. Anti-coagulant administration is often given before the start of the operation. There are concerns with the potential of increased risk of bleeding and so many surgeons start giving anti-coagulants the first 6 hours after surgery. [4]

Postoperative thrombosis prophylaxis remains a priority for most surgeons. Risk factors for developing thrombosis after surgery are pregnancy, age, contraceptive use, hormone replacement therapy, infection, malignant disease, venous insufficiency, obesity, heart failure, antipospholipid syndrome, and antithrombin deficiency.[4]

Intermittent pneumatic compression devices are used post-surgically to promote venous circulation.[5][6]

Physical thrombosis prophlaxis treatments are the implementation of early mobilization, physical therapy, patient education to teach the use of exercises, encouragement of the clinician to promote mobilization, and the fitting and use of high quality compression stockings.[4]

Procedure

The application of antiembolism stockings (TED stockings) can be used prophylactically to prevent thrombosis. The procedure is not required to be aseptic, except for proper hand-washing techniques.[6]

Research

An international registry and risk assessment calculator is being used to centralize data on post-surgical venous thrombosis and its prevention.[7]

References

  1. ↑ Martinelli I, Bucciarelli P, Mannucci PM (2010). "Thrombotic risk factors: basic pathophysiology". Crit Care Med 38 (2 Suppl): S3–9. doi:10.1097/CCM.0b013e3181c9cbd9. PMID 20083911.
  2. ↑ Hecht, M. E. (2010). A practical guide to hip surgery: from pre-op to recovery. Sunrise River Press. ISBN 978-1-934716-12-0.
  3. ↑ Gould MK, Garcia DA, Wren SM, et al. (2012). "Prevention of VTE in nonorthopedic surgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines". Chest 141 (suppl 2): e227S–e277S. doi:10.1378/chest.11-2297. PMC 3278061. PMID 22315263.
  4. 1 2 3 Abele, H (2014). Atlas of gynecologic surgery. Stuttgart: Thieme. ISBN 9783136507049; Access provided by the University of Pittsburgh
  5. ↑ Gould MK, Garcia DA, Wren SM, Karanicolas PJ, Arcelus JI, Heit JA, Samama CM (2012). "Prevention of VTE in Nonorthopedic Surgical Patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines". Chest 141 (2 suppl): e227S–e277S. doi:10.1378/chest.11-2297. PMC 3278061. PMID 22315263.
  6. 1 2 Rosdahl, Caroline (2012). Textbook of basic nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605477725.
  7. ↑ >"Computerized Registry of Patients with Veneous Thromboembolism - RIETE Registry". S & H Medical Science Service. Retrieved 2016-02-13.
This article is issued from Wikipedia - version of the Sunday, February 28, 2016. The text is available under the Creative Commons Attribution/Share Alike but additional terms may apply for the media files.