Which of the following is the best way of preventing the development of deep vein thrombosis (DVT) in the postoperative period?
Correct Answer: Prophylactic heparin
Description: Patients are at increased risk for developing venous thromboembolism after:
Major abdominal surgery
Major orthopaedic surgery
Has sustained major trauma
Has prolonged immobility (>3 days)
These patients need some form of prophylaxis. The prophylaxis can be mechanical or pharmacological.
Prophylaxis for DVT
Mechanical Prophylaxis include :
Early ambulation
It is the simplest method of prophylaxis
It acts by activating the calf pump mechanism
Pneumatic compression devices
It is the most common method of prophylaxis
Pneumatic compresses prevents the stasis by periodically compressing the calves.
Pharmacological Prophylaxis include
Use of unfractionated heparin - Now being replaced by fractionated low molecular weight heparin
Use of fractionated low molecular - Better efficacy than unfractionated heparin
weight heparin - No laboratory monitoring is necessary
Comparison of low molecular weight heparin (LMWH) with mechanical prophylaxis demonstrates superiority of low molecular weight heparin (LMWH) in reduction of the development of venous thromboembolic disease. Prospective trials evaluating LMWH in head injured and trauma patients have also proven the safety of LMWH with no increase in intracranial bleeding or major bleeding at other sites. In addition, LMWH shows significant reduction in the development of venous thromboembolism compared to other methods.
In short, LMWH should be considered the optimal method of prophylaxis in moderate and high risk patients. Even the traditional reluctance to use heparin in high risk groups such as the multiply injured trauma patient and the injured patient must be reexamined, given the efficacy and safety profile of LMWH in multiple prospective trials.
Category:
Surgery
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now