| Abstract |
Objective: After major orthopedic surgery, venous thromboembolism is a serious method that can reduce complications. The main point of this study is to provide the best preventive measures to reduce postoperative venous thromboembolism. Methods: A comparison of 315 patients with deep vein thrombosis who underwent major bone surgery and 618 patients with deep vein thrombosis diagnosed by continuous general surgery in the prospective registry. Orthopedic patients have fewer indwelling central venous catheters (14.0% vs 46.4%, P0.001) and the incidence of congestive heart failure is lower (7.0% vs 13.4%, P0.001), cancer (5.1% vs 28.6%, P0.001) and diabetes (7.0%vs12.6%, P0.004). Limb discomfort (43.5%vs30.3%, P<.0001) and erythema (10.1%vs4.8%, P0.001) are more common in orthopedic patients, but dyspnea is less common (11.4%vs18.0%, P0. 005). Use gradient compression stockings (19.4% vs. 15.0%, P0.04), low molecular weight heparin (18.7% vs. 12.1%, P0.003) and warfarin (31.7% vs. 11.0%, P0.001) for prevention Deep vein thrombosis was in the plastic surgery group. Orthopedic surgery patients had a higher frequency of thrombosis in the deep veins of the calf than patients receiving general treatment (38.4% vs. 2.1%, P0.001). 28% of people in both groups did not receive prevention. In short, although orthopedic patients with fewer comorbidities are accompanied by deep vein thrombosis, deep vein thrombosis of the calf is still particularly vulnerable. Inadequate prevention of venous rate thromboembolism. Results: For patients undergoing major orthopedic surgery, it is recommended to use one of the following methods instead of no antithrombotic prevention: or intermittent pneumatic compression device (IPCD) (level 1C) for at least 10 to 14 days. For patients with isolated lower extremity injuries who require lower extremity fixation, it is recommended not to prevent thrombosis (level 2B). It is recommended not to perform Doppler (or duplex) ultrasound examination (level 1B) before discharge from the hospital. For patients with isolated lower extremity injuries who require lower extremity fixation, thromboprophylaxis is not recommended (Grade 2B). For knee arthroscopy patients without a history of VTE, thromboprophylaxis is not recommended (Grade 2B). For patients with contraindications to drug and mechanical thrombosis prevention (Grade 2C), it is recommended not to use inferior vena cava filter placement for primary prevention. It is recommended not to perform Doppler (or duplex) ultrasound examination (level 1B) before leaving the hospital. Conclusion: For patients with isolated lower extremity injury who require lower extremity fixation, thromboprophylaxis is not recommended (Grade 2B). The best strategies for preventing thrombosis after major orthopedic surgery include pharmacological and mechanical methods. This study recommends the use of pharmacological methods for prevention.
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