The bleeding rates associated with IPCD usage are considerably smaller than with chemoprophylaxis. In patients at increased bleeding risk, the ACCP recommends an intermittent pneumatic compression device (IPCD) or no prophylaxis after major orthopaedic surgery (grade 2C). Chemoprophylaxis with agents that affect the clotting cascade carries an increased risk of bleeding, hematoma, wound drainage, infection, and wound-healing problems. For patients undergoing THA or TKA, the ACCP recommends “low molecular weight heparin (LMWH) fondaparinux dabigatran apixaban rivaroxaban low-dose unfractionated heparin adjusted-dose vitamin K antagonist aspirin (all grade 1B) or an intermittent pneumatic compression device (grade 1C) for a minimum of 10 to 14 days”. The American College of Chest Physicians (ACCP) developed a revised set of guidelines in 2012 for chemoprophylaxis after total hip (THA) or total knee arthroplasty (TKA). Ĭhemoprophylaxis after total joint arthroplasty has become the standard of care and includes oral or injectable agents. With the routine use of thromboprophylaxis, current rates of symptomatic VTE are approximately 0.9% after hip arthroplasty and 1.9% after knee arthroplasty. Before the routine use of prophylaxis, the rate of symptomatic VTE events was between 15 and 30%. Venous thromboembolism (VTE) is a concerning complication after total joint arthroplasty.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |