Effects of fondaparinux on wound drainage after total hip and knee arthroplasty

Abstract

Fondaparinux is an effective drug for VTE prophylaxis in total joint arthroplasty with wound drainage and LOS comparable to historical controls of enoxaparin, warfarin, and rivaroxaban.

Study on the safety and effectiveness of low-dose vs. regular-dose fondaparinux in preventing venous thromboembolism prophylaxis following total knee arthroplasty

“…The Weiss method was used to calculate wound drainage; the surgical wound was dry in 83% of patients receiving aspirin and 77% of patients who received enoxaparin on day 5 post-surgery (15). Another research found that by day 5 after surgery, the wounds of 83% of patients treated with 2.5 mg of fondaparinux were dry (16). Our results revealed that the surgical wounds of 90% of patients who were given 1.5 mg fondaparinux were dry on day 5 post-surgery.…”

The draining surgical wound post total hip and knee arthroplasty: what are my options? A narrative review

“… 22 Anti-coagulation therapies used include warfarin, enoxaparin (low molecular weight heparin), fondaparinux, rivaroxaban and aspirin to mitigate the risk of venous thromboembolic events (VTE). 4 , 31 Each of the agents have different mechanisms of actions, dosages and routes of administration, with negative and positive attributes regarding their uses that need to be considered in VTE prophylaxis. Peri-operative VTE can be catastrophic but so too can deep and superficial wound complications, therefore risk stratification is needed to balance anti-coagulation peri-operatively, and patients requiring therapeutic anti-coagulation need to be counselled about the risk regarding wound complications and infection.…”

“… 11 Jones et al 34 showed that the use of LMWH and the use of aspirin resulted in a 4.92 and 3.64 times greater increase in wound discharge respectively when compared to the use of no pharmacological thromboprophylaxis. Lum et al 31 proposed that prolonged wound drainage due to anti-coagulation had a positive correlation with increased length of stay (LOS) in hospital. This was supported by Patel et al, 4 therefore using LOS as a surrogate for wound drainage assists in comparing anti-coagulation agents.…”

“…This was supported by Patel et al, 4 therefore using LOS as a surrogate for wound drainage assists in comparing anti-coagulation agents. 31 In order of shortest to longest LOS, the use of aspirin was 2.6 days, warfarin was 3.7 days, Fondaparinux was 3.77 days, rivaroxaban was 4.1 days and enoxaparin was five days. 31 There have been numerous studies reporting the effects of various anti-coagulation therapies, aiming to identify the ideal therapy providing adequate prophylactic effect against VTE while limiting post-operative surgical site complications.…”

“… 31 In order of shortest to longest LOS, the use of aspirin was 2.6 days, warfarin was 3.7 days, Fondaparinux was 3.77 days, rivaroxaban was 4.1 days and enoxaparin was five days. 31 There have been numerous studies reporting the effects of various anti-coagulation therapies, aiming to identify the ideal therapy providing adequate prophylactic effect against VTE while limiting post-operative surgical site complications. 35 Various guidelines have been proposed, and although aspirin seems to be favoured for VTE prophylaxis when considering possible wound complications, the debate continues for the most optimal prophylactic regimen.…”