Foot pump prophylaxis for deep venous thrombosis?rate of effective usage following knee and hip arthroplasty

Abstract

We recorded the usage of foot pumps during the post-operative period in 29 patients undergoing knee or hip arthroplasty and made 621 recordings. Effective utilisation of foot pumps was seen in 37.2% of cases. There was a gradual reduction in correct utilisation with each day that passed post-operatively (day 1, 60.4%; day 2, 48.8%; day 3, 28.8%; day 4, 21.4%; day 5, 23%). This gradual reduction was statistically significant (P=0.001) and mainly occurred between the second and third postoperative days. Effective usage was 60.2% overall at night and 36.4% during the day. Our results question the efficiency of foot pumps in deep venous thrombosis prophylaxis in the context of a true clinical setting.Résumé Nous avons étudié l'usage de pompes plantaires chez 29 malades pendant la période postopératoire aprés arthroplastie du genou ou de la hanche. Un total de 621 enregistrements a été fait. Une utilisation efficace des pompes a été notée dans 37.2% de cas. Il y avait une réduction graduelle de l'utilisation correcte au fil des jours post-opératoires (1er jour, 60.4%; 2e jour, 48.8%; 3e jour, 28.8%; 4e jour, 21.4%; 5e jour, 23%). Cette ré-duction graduelle était statistiquement significative (P=0.001) et s'est principalement produite entre les 2e et 3e jours postopératoires. L'usage efficace était de 60.2% la nuit et 36.4% dans la journée. Nos résultats questionnent l'efficacité des pompes plantaires dans la prophylaxie de la thrombose veineuse profonde dans un contexte clinique réel.

Foot pumps without graduated compression stockings for prevention of deep-vein thrombosis in total joint replacement: efficacy, safety and patient compliance

“…Following TKR, the effectiveness of foot pumps is less certain, with some studies reporting a benefit and others not [3,18]. In some of these studies GCS were not used.…”

“…Compliance and tolerance have been reported to be a problem with the use of pneumatic compression systems [3,12]. Pitto et al reported a termination rate of 13.8% (16/116 patients) [11].…”

“…The International Consensus Statement Group reported that mechanical prophylaxis with foot pumps should be considered to be a "Grade A" recommendation for the prevention of DVT following THR [6]. Results from four independent randomised clinical trials have shown that mechanical prophylaxis with foot pumps in THR achieved equivalent -if not superior -results compared to chemical management [5,11,13,16], but the tolerance of the device has been a problem for some patients [3,12]. The effective action of the foot pumps depends on various factors, including the frequency and pressure of the impulses and the dependency of the lower extremities [1,4,10].…”

The prevention of pregnancy‐related venous thromboembolism

“…The same study reported that only five out of the 244 patients required antenatal thromboprophylaxis, however, two of these were not assessed appropriately. There is evidence that correct use and compliance with of foot pumps is also an issue, with appropriate use as low as 36% (Charalambous et al, 2003).…”

Tromboprofilaxia primária

“…(A) (8) Em cirurgias ortopédicas, também há alguns estudos com as bombas pneumá-ticas para pés. (9) Os métodos mecânicos também podem ser usados em associação a medidas farmacológicas em pacientes com alto risco de TEV. (A) (10) Cirurgias neurológicas maiores requerem profilaxia para TEV.…”