Role of calf muscle stimulation in the prevention of DVT in Indian patients undergoing surgeries for fractures around the hip

Abstract

Background:The venous stasis of soleal vein during surgery may be an important factor in the development of deep vein thrombosis (DVT). The stimulation of calf muscle during surgery may help in preventing DVT. The present study is conducted to evaluate the role of peroperative calf muscle electrostimulation in prevention of DVT in patients undergoing surgeries around the hip joint.Materials and Methods:The study comprised 200 patients undergoing surgeries around the hip joint. The patients having risk factors (such as previous myocardial infarction, malignancies, paraplegia or lower limb monoplegia, previous history of DVT or varicose veins, etc.) for the development of DVT were excluded. They were randomized into two groups: 100 cases were given peroperative calf muscle electrostimulation for DVT prophylaxis (Group A) and the remaining 100 patients were taken as controls without any prophylaxis (Group B). The color Doppler ultrasound was performed to exclude pre-existing DVT and on 7th day postoperative to find out the incidence of DVT in both the groups.Results:Two patients among Group A and six patients among Group B demonstrated DVT on ultrasonography, but the difference was not found to be statistically significant (P=0.279). None of the patients had any clinical evidence of DVT.Conclusion:The role of peroperative calf muscle electrostimulation for DVT prophylaxis remains controversial. The risk of developing DVT in patients undergoing surgeries around the hip joint is very less in patients analysed in our series.

Neuromuscular electrical stimulation for thromboprophylaxis: A systematic review

“…However, the incidence of DVT in patients with malignant disease was significantly lower Williams et al 23 Geko T-1 1 70-560 ms 2 7 N R Izumi et al 24 SEN-52901 10 NR NR 100 Jawad et al 25 Geko T-1 1 70-560 ms 2 7 N R Warwick et al 35 Geko T-1 1 0-400 ms 2 7 N R Broderick et al 36 Duo Williams et al 23 Izumi et al 24 Jawad et al 25 Goyal et al 26 Velmahos et al 27 Merli et al 29 Bostrom et al 30 Lindströ m et al 28 Doran et al 31 Doran and White 32…”

“…The study addresses an appropriate and clearly focused question 23 Izumi et al 24 Jawad et al 25 Goyal et al 26 Velmahos et al 27 Merli et al 29 Bostrom et al 30 Lindströ m et al 28 Doran et al 31 Doran and White 32…”

Is pre-operative assessment of coagulation profile with Thrombelastography (TEG) useful in predicting venous thromboembolism (VTE) following orthopaedic surgery?

“…12 Agarwala et al, on the other hand showed an incidence of 60% in 50 patients who did not have prophylaxis peri-operatively using venography as the end point. 2 In our series, the incidence of DVT was 7%.…”

“…2 In our series, the incidence of DVT was 7%. Most other authors 1,3,4,9,12,19,20,[22][23][24] who have reported a similar incidence had also used Colour Doppler as the end point, rather than venography. Venography may pick up a lot of asymptomatic DVTs, 2,5,7 which may not be clinically relevant.…”

Mechanical Ways of Thromboprophylaxis and Therapy of Chronic Venous Insufficiency: Accent – Compression Therapy

“…Это может быть объяснением того факта, что ЭМС, применяемое менее, чем 5 раз в день (с временными промежутками, достаточными для образования тромбов), клинически неэффективно. Интраоперационное применение ЭМС является исключе-нием, т. к. в большинстве случаев формирование ТГВ про-исходит во время операции, следовательно, одной сессии может быть достаточно, чтобы существенно сократить частоту развития ранних ВТЭО [27,28]. Некоторый про-цент предотвращения образования тромбов и связанная с ним активация тромболитического каскада могут объ-яснить изменения фактора коагуляции, вызванные ЭМС.…”