Vaskulárna medicína 1/2010

Prophylaxis of venous thromboembolism in orthopaedic surgery

The thromboembolic disease in orthopaedics remains a threatening complication in early as well as in late post-operative period. The determinant of creation and development of thromboembolism is a deep venous thrombosis, which in orthopaedics begins in 95% in the deep venous system of the lower limbs. The minority of the cases arise from the sacral pelvic plexus, superficial veins of lower extremities, cavities of right heart and very rarely from the venous system of upper extremities. To express precisely the risk of patients with mentioned risk factors is very difficult and complicated especially in orthopaedic patients, where in many cases the accumulation of several factors in one patient increases the risk. Prevention of the deep venous thrombosis becomes a logic result of all efforts to decrease the incidence of the chronic venous insufficiency and to prevent death due to a pulmonary embolism. Systematic prophylaxis and detection of a deep flebothrombosis seems to be the most effective approach to solve this problem. The ideal prophylaxis should be easy, safe, effective, cheap, available, without or with simple monitoring. In the question of indication and need of thromboprophylaxis mainly in operative specializations is generally accepted the fact, that an operation without adequate form of prophylaxis is non lege artis procedure.

Keywords: venous thromboembolism, operations in orthopedics, methods of thromboprophylaxis