Wound Discharge After Pharmacological Thromboprophylaxis in Lower Limb Arthroplasty
| Autor: | Piers Yates, Christopher W. Jones, Zacharia Joseph, G. Goh, S. Spasojevic, David Wood |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class Arthroplasty Replacement Hip Wound discharge medicine.medical_treatment Low molecular weight heparin Lower limb 03 medical and health sciences Postoperative Complications 0302 clinical medicine Thromboembolism medicine Humans Orthopedics and Sports Medicine Prospective Studies 030212 general & internal medicine Enoxaparin Arthroplasty Replacement Knee Aged Aged 80 and over Venous Thrombosis 030222 orthopedics Aspirin business.industry Anticoagulants Surgical wound Heparin Low-Molecular-Weight Middle Aged Arthroplasty Surgery Lower Extremity Elective Surgical Procedures Orthopedic surgery Female Observational study Pulmonary Embolism business medicine.drug |
| Zdroj: | The Journal of Arthroplasty. 33:224-229 |
| ISSN: | 0883-5403 |
| DOI: | 10.1016/j.arth.2017.07.046 |
| Popis: | The benefits vs risk of pharmacological prophylaxis for thromboembolic disease in orthopedic patients remain controversial. Pharmacological thromboprophylaxis regimes are commonly used in this patient group. Few studies specifically examine wound complications attributable to this therapy. In this prospective trial, we investigated the effect of various regimens on postoperative wounds.A prospective, observational, multicenter study involving patients undergoing elective hip or knee arthroplasty was undertaken. Patients were divided into 3 groups depending on thromboprophylaxis: no anticoagulation, aspirin, or low molecular weight heparin (LMWH) (enoxaparin). Surgical wounds were evaluated for each regime using the Southampton Wound Assessment Score.Over a 12-month period, 327 patients were enrolled with a mean age of 68.1 years (±11.2 years). There were 105 patients in the no anticoagulation group (32.1%), 97 patients in the aspirin group (29.7%), and 125 patients in the LMWH group (38.2%). Wound scores were evaluated for evidence and amount of discharge. The use of LMWH conferred a 4.92 times greater risk and aspirin a 3.64 times greater risk of wound discharge than no pharmacological thromboprophylaxis (P.0001). There were no significant differences in the incidence of deep vein thrombosis or pulmonary embolus between groups either as an inpatient or postdischarge.There is a significant increase in the risk of wound discharge when aspirin or LMWH is used in arthroplasty patients. As potential complications of wound problems are significant, a more balanced view of risk vs benefit needs to be taken when prescribing thromboprophylaxis for this patient group. |
| Databáze: | OpenAIRE |
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