The Phlebo-Dynastat: A New and Effective Method of Prophylaxis for Deep Vein Thrombosis

Abstract

Peripheral deep vein thrombosis (DVT) is a frequent complication of orthopedic surgery. Evaluation of new methods of prophylaxis is necessitated by the disadvantages of the popular low dose heparin method.In a previous study we found a 50% (20/40) incidence of DVT in patients undergoing total hip or knee replacements. In this high risk group, we undertook a prospective study of the prophylactic value of the Phlebo-Dynastat - a previously undescribed intermittent pneumatic compression device which alternately inflates thigh and calf cuffs to a maximum pressure of 30 mmHg. Seven patients had total knee replacements and 19 had total hip replacements. 125I-fibrinogen scanning was started pre-operatively in all patients. Venography was performed on 25 limbs in 19 patients. Patients were assigned to treated or untreated groups by random numbers. Seven of 12 untreated patients developed DVT complicated by pulmonary embolism in 3, but only 1/14 patients in the treated group developed DVT. This difference is significant at the 0.009 level (Fisher’s exact probability). DVT did not occur in 3 treated patients with shortened activated partial thromboplastin time but occurred in 2/3 untreated patients.We are reporting a new previously undescribed method for preventing DVT and have demonstrated its effectiveness.