Which of the following is the best way of preventing development deep vein thrombosis (DVT) in postoperative period?
Correct Answer: Prophylactic heparin
Description: Deep vein thrombosis Deep vein thrombosis (DVT) is a well-known and, when complicated by pulmonary embolus, potentially fatal complication of surgery. All hospitals must have a process for screening all surgical patients to identify those at risk and for implementing prophylactic measures. There is international agreement on risk and therapeutic options. Methods of prevention are guided by the risk score and include the use of compression stockings, calf pumps and pharmacological agents, such as low molecular weight heparin. The symptoms and signs of DVT include calf pain, swelling, warmth, redness and engorged veins. However, most will show no physical signs. On palpation the muscle may be tender and there may be a positive Homans' sign (calf pain on dorsiflexion of the foot), but this test is neither sensitive nor specific. Duplex Doppler ultrasound and venography can be used to assess flow and the presence of a thrombosis. Other investigations include D-dimer. If a significant DVT is found (one that extends above the knee), treatment with parenteralanticoagulation initially, followed by longer-term warfarin or new oral anticoagulant. In some patients with a large DVT, a caval filter may be required to decrease the possibility of pulmonary embolism. Ref: Bailey and love 27th edition Pgno : 296
Category:
Surgery
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