Calf Compression for Prevention of Thromboembolism Following Hip Surgery

Öhlund, Carl; Fransson, Sven-Göran; Starck, Sven-Åke

doi:10.3109/17453678308992929

Cited by 22 publications

(16 citation statements)

References 8 publications

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“…[42][43][44][45] Background (pharmacologic) prophylaxis included LDUH in fi ve studies, dextran in three studies, LMWH in one study, and aspirin in one study. Many of the studies were limited by small samples, incomplete blinding, uncertain concealment of the allocation sequence, and measurement of surrogate outcomes (Table S4).…”

Section: Mechanical Prophylaxis Plus Pharmacologic Prophylaxis Vs Phamentioning

confidence: 99%

Prevention of VTE in Nonorthopedic Surgical Patients

Gould

García

Wren

et al. 2012

Chest

1,857

744

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(Grade 2C) prophylaxis be used other than early ambulation. For patients at low risk for VTE ( ‫ف‬ 1.5%), we suggest mechanical prophylaxis, preferably with intermittent pneumatic compression (IPC), over no prophylaxis (Grade 2C). For patients at moderate risk for VTE ( ‫ف‬ 3%) who are not at high risk for major bleeding complications, we suggest low-molecular-weight heparin (LMWH) (Grade 2B), low-dose unfractionated heparin (Grade 2B), or mechanical prophylaxis with IPC (Grade 2C) over no prophylaxis. For patients at high risk for VTE ( ‫ف‬ 6%) who are not at high risk for major bleeding complications, we recommend pharmacologic prophylaxis with LMWH (Grade 1B) or low-dose unfractionated heparin (Grade 1B) over no prophylaxis. In these patients, we suggest adding mechanical prophylaxis with elastic stockings or IPC to pharmacologic prophylaxis (Grade 2C). For patients at high risk for VTE undergoing abdominal or pelvic surgery for cancer, we recommend extended-duration, postoperative, pharmacologic prophylaxis (4 weeks) with LMWH over limited-duration prophylaxis (Grade 1B). For patients at moderate to high risk for VTE who are at high risk for major bleeding complications or those in whom the consequences of bleeding are believed to be particularly severe, we suggest use of mechanical prophylaxis, preferably with IPC, over no prophylaxis until the risk of bleeding diminishes and pharmacologic prophylaxis may be initiated (Grade 2C). For patients in all risk groups, we suggest that an inferior vena cava fi lter not be used for primary VTE prevention (Grade 2C) and that surveillance with venous compression ultrasonography should not be performed (Grade 2C). We developed similar recommendations for other nonorthopedic surgical populations. Conclusions: Optimal thromboprophylaxis in nonorthopedic surgical patients will consider the risks of VTE and bleeding complications as well as the values and preferences of individual patients. CHEST 2012; 141(2)(Suppl):e227S-e277SAbbreviations: CABG 5 coronary artery bypass graft; ES 5 elastic stockings; ICH 5 intracranial hemorrhage; IPC 5 intermittent pneumatic compression; IVC 5 inferior vena cava; LDUH 5 low-dose unfractionated heparin; LMWH 5 low-molecular-weight heparin; PE 5 pulmonary embolism; QALY 5 quality-adjusted life year; RR 5 risk ratio; VCU 5 venous compression ultrasonography

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Section: Mechanical Prophylaxis Plus Pharmacologic Prophylaxis Vs Phamentioning

confidence: 99%

Prevention of VTE in Nonorthopedic Surgical Patients

Gould

García

Wren

et al. 2012

Chest

1,857

744

View full text Add to dashboard Cite

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“…Their results were presented as overall thrombosis rates and there was no differentiation between ipsilateral or contralateral legs, nor was there any clarification as to the site of thrombi. In a third study, Ohlund et al (1983) reported their findings in 62 patients who had a mixture of hip procedures. Using the fibrinogen uptake test, they favoured the use of graded compression stockings, but only in male patients.…”

Section: Discussionmentioning

confidence: 99%

“…A postal survey of orthopaedic surgeons in the UK showed that 68% used graded compression stockings as prophylaxis for DVT (Laverick, Croal and Mollan 1991). Their efficacy has been well documented in abdominal surgery (Holford 1976;Scurr et al 1977;Allan et al 1983;Turner, Cole and Brooks 1984;Wille-Jorgensen et al 1985;Jeffery and Nicolaides 1990), but there is little information on their use in orthopaedic surgery (Barnes et al 1978;Ishak and Morley 1981;Ohlund, Fransson and Starck 1983).…”

Section: Graded Compression Stockings For Prevention Of Deep-vein Thrmentioning

confidence: 99%

Graded Compression Stockings for Prevention of Deep-Vein Thrombosis After Hip and Knee Replacement

Hui

Heras-Palou

Dunn

et al. 1996

The Journal of Bone and Joint Surgery. British volume

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We performed a prospective, randomised controlled trial in 177 patients who were having either total hip or knee replacement, to evaluate the use of both above-and below-knee graded compression stockings in the prevention of deep-vein thrombosis (DVT).With above-knee stockings, we found no significant reduction of the overall, proximal or major calf (> 5 cm) DVT rates. With below-knee stockings, the overall thrombosis rate was similar to that of the control group but the stockings appeared to have altered the pattern of thrombosis. Patients who had total hip replacement and wore below-knee stockings had a significantly higher rate of proximal or major calf DVT (p = 0.03). This pattern was reversed in patients with total knee replacement who developed a significantly lower rate of proximal or major calf DVT with below-knee stockings (p < 0.05).Our results showed that, with the exception of below-knee stockings in knee replacement patients, graded compression stockings were ineffective in preventing DVT after hip or knee replacement surgery.

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“…19 AES are time-consuming to size and fit, and often do not provide the correct pressure profile, apart from being generally disliked by patients who prefer parenteral anticoagulation. 20,21 Seven studies were excluded from analysis because they entailed pharmacological agents not recommended in the NICE guidelines; 5 of these involved dextran 70, [22][23][24][25][26] one involved hypotensive anaesthesia, 16 and one involved dihydroergotamine. 27 Although there were 1171 patients in the 4 studies included; 856 (73%) of them were from a single study.…”

Section: Discussionmentioning

confidence: 99%

Review Article: Anti-Embolism Stockings

Patel

Khakha

Gibbs

2013

J Orthop Surg (Hong Kong)

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Excellence (NICE) guidelines recommend combined mechanical and pharmacological prophylaxis to reduce the risk of venous thromboembolism (VTE) in patients undergoing orthopaedic surgery. There is increasing evidence that anti-embolic stockings (AES) have little effect on reducing such risk. Articles in the MEDLINE, EMBASE, and Cochrane Library were reviewed. Studies on the use of pharmacological prophylaxis recommended in the 2010 NICE guidelines including low-molecular-weight heparin, unfractionated heparin, rivaroxaban, and dabigatran with and without AES in patients undergoing orthopaedic surgery were included. A total of 1171 trauma and elective orthopaedic patients in 4 studies were included; 587 received pharmacological prophylaxis alone, and 584 received a combination of pharmacological prophylaxis and above-or belowknee AES. Of the respective patients, 44 (7.5%) and 31 (5.3%) developed deep vein thrombosis (p=0. Surgery 2013;21(3):361-4 and 7 (1.2%) and 9 (1.5%) developed pulmonary embolism (p=0.8493). The overall VTE rates did not differ significantly (p=0.2864). No death from VTE was reported. Addition of AES did not confer significant benefit in terms of reducing the risk of VTE in orthopaedic patients. Journal of Orthopaedic

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Calf Compression for Prevention of Thromboembolism Following Hip Surgery

Cited by 22 publications

References 8 publications

Prevention of VTE in Nonorthopedic Surgical Patients

Prevention of VTE in Nonorthopedic Surgical Patients

Graded Compression Stockings for Prevention of Deep-Vein Thrombosis After Hip and Knee Replacement

Review Article: Anti-Embolism Stockings

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