Postoperative Deep-Vein Thrombosis

Flanc, C; Kakkar, Vijay V.; Clarke, Maxine

doi:10.1016/s0140-6736(69)91585-2

Cited by 133 publications

(4 citation statements)

References 8 publications

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“…The findings from this investigation may provide an explanation for the underlying causes of failure of compression of the leg to prevent deep vein thrombosis (Flanc et al, 1969;Rosengarten et al, 1970). Both Flanc and Rosengarten and their associates conducted trials to evaluate the efficacy of compression stockings in the prophylaxis of deep venous thrombosis in surgical patients.…”

Section: Discussionmentioning

confidence: 94%

Effects of Externally Applied Pressure on the Haemodynamics of the Lower Limb

Sabri¹,

Roberts²,

Cotton³

1971

BMJ

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SummaryThe effects of externally applied pressure of 5-150 mm Hg on the haemodynamics of the leg of dog and man were investigated. The criteria used for the assessments included femoral arterial and venous blood flow as well as vascular hydraulic conductance. The results indicated that external pressure of 5 mm Hg results in a very small non-significant increase in the femoral arterial and venous flow. Higher external pressure of 15 mm Hg or more significantly reduces the femoral arterial and

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Section: Discussionmentioning

confidence: 94%

Effects of Externally Applied Pressure on the Haemodynamics of the Lower Limb

Sabri¹,

Roberts²,

Cotton³

1971

BMJ

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“…Rosengarten y Laird, 1971 32 Browse y cols, 1974 33 Compresión elástica Flanc y cols, 1969 34 Rosengartenycols, 1970 35 Tsapogas y cols, 1971 36 Browse y cols, 1974 33 Holford, 1976 37 Lewis y cols, 1976 38 Scurr y cols, 1977 39 Ohlund y cols, 1983 40 Estimulación muscular eléctrica Browse y Negus, 1970 41 Nicolaides y cols, 1972 42 Becker y Schampi, 1973 43 Rosenberg y cols, 1975 44 Compresión neumática intermitente Sabri y cols, 1972 45 Hills y cols, 1972 46 Roberts y Cotton, 1974 47 Clarks y cols, 1974 48 Knight y Dawson, 1976 49 Turpie• y cols, 1977 5 º Pedegana y cols, 1977 51 Coe y cols, 1978 52 Skillman y cols, 1978 53 Hull y cols, 1979 54 McKenna y cols, 1980 55 Gallus y cols, 1983 mayor ventaja es la ausencia de efectos colaterales, por lo que es particularmente atractiva en pacientes con alto riesgo de presentar complicaciones hemorrágicas por el tratamiento con heparina a dosis bajas, teniendo especial interés los resultados obtenidos en cirugía prostática 52 , neurocirugía 5 º• 53 y cirugía ortopédica de rodilla 54 • En general, se puede concluir que los diferentes métodos físicos consiguen una reducción del estasis venoso y disminuyen la incidencia de TVP, excepto en los pacientes de alto riesgo en que la intervención quirúrgica es consecuencia de un proceso neoplásico. Sin embargo no hay datos que permitan asegurar que estas medidas sean capaces de disminuir la extensión del trombo y, mucho menos, la mortalidad secundaria a embolismo pulmonar fatal.…”

Section: Elevación Extremidadesunclassified

Tratamiento profiláctico de la enfermedad tromboembólica en el paciente quirúrgico

Rocha¹,

Páramo²,

Cuesta³

et al. 2017

revista-de-medicina

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“…In contrast, graduated elastic compression stockings applied to the calf do appear to significantly reduce the incidence of DVT in patients undergoing major abdominal surgery [6,7]; however, the limitations of intensive physical prophylaxis in general surgical cases were clearly demonstrated by Flanc and colleagues [8], using the ~25I-labelled fibrinogen test to detect leg vein thrombi. In this study, patients wore elastic stockings from admission to discharge, had frequent and vigorous leg exercises before and after operation, had the foot of the bed elevated, and were provided with a foot board to aid plantar flexion against resistance.…”

Section: Elimination Of Stasismentioning

confidence: 99%

Prophylaxis of venous thromboembolism

Kakkar

Stringer

1990

World j. surg.

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The objective of prophylaxis in venous thromboembolism is, first, to prevent fatal pulmonary embolism and, second, to reduce the morbidity associated with deep vein thrombosis (DVT) and the postphlebitic limb. This should now be standard practice for most patients over 40 years of age undergoing major surgery and for younger patients with a history of venous thromboembolism. Particularly high-risk groups include patients over 60 years of age undergoing major surgery, those with malignancy, and those requiring hip operations.Low-dose subcutaneous heparin 5,000 IU commencing 2 hours preoperatively and continuing 12 hourly until the patient is fully mobile is unequivocally effective in preventing DVT in medical and surgical patients and, most importantly, significantly reduces the incidence of fatal postoperative pulmonary embolism and total mortality. Such prophylaxis, in the presence of established DVT, also limits proximal clot propagation, which is the precursor of major pulmonary embolism. Low-dose heparin prophylaxis is associated with a small risk of bleeding complications, evidenced mostly by an increased frequency of wound hematoma rather than major clinical hemorrhage.Low molecular weight heparin fragments (e.g., Fragmin | Choay% Enoxaparine | are emerging as useful alternative agents, having the advantage of once daily administration and yet providing similar efficacy in the prevention of DVT. Mechanical methods of prevention which counteract venous stasis, such as graduated elastic compression stockings, are also useful in protecting against DVT but have not been shown to prevent fatal postoperative pulmonary embolism. They are recommended particularly for patients in whom heparin prophylaxis is best avoided (e.g., neurosurgery) and possibly in combination with heparin in very high-risk patients.Venous thromboembolism continues to be a frequent cause of morbidity and mortality in medical and surgical practice. Apart from the immediate risk to life, there are later sequelae of deep vein thrombosis, namely, swelling of the legs, varicose veins, and venous ulceration. It is sometimes asked whether postoperative pulmonary embolism is preventable and, furthermore, whether it is worth preventing since the overall mortality due to this complication is low and all prophylactic methods require some supervision and extra work. This review aims to demonstrate that not only should venous thromboembolism be prevented but also currently available prophylactic measures make this a practical proposition.

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Postoperative Deep-Vein Thrombosis

Cited by 133 publications

References 8 publications

Effects of Externally Applied Pressure on the Haemodynamics of the Lower Limb

Effects of Externally Applied Pressure on the Haemodynamics of the Lower Limb

Tratamiento profiláctico de la enfermedad tromboembólica en el paciente quirúrgico

Prophylaxis of venous thromboembolism

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