Influence of compression therapy following varicose vein surgery: a prospective randomized study / Influência da terapia compressiva no pós-operatório de flebectomia: um estudo prospectivo e randomizado

Abstract Background The use of compression dressings after phlebectomy is based solely on clinical experience due to the lack of a unified set of definitive recommendations, which makes clinical practice extremely heterogeneous. Objectives To evaluate compression therapy with elastic stockings for 7 days after phlebectomy. Methods We randomly allocated 104 lower limbs with disease classified as C1 and C2 to 1 of 2 groups: an intervention group (64 limbs) - wearing elastic compression stockings for the first 7 days after phlebectomy; or a control group (40 limbs) - given conventional bandaging for 24 hours postoperatively. We compared clinical response by analyzing the evolution of symptoms, hematoma formation, and preoperative vs. postoperative limb volume. Results Pain (median 1.0 vs. 1.5, p=0.0320) and limb volume (mean 43.7 vs. 99.8, p=0.0071) were significantly improved in patients wearing elastic compression stockings for 7 days after phlebectomy compared with controls. Conclusions Use of elastic compression therapy for 7 days after phlebectomy was effective for improving pain and lower limb volume.

Resumo Contexto O uso de curativos após flebectomia é baseado apenas na experiência clínica, visto que não existe um conjunto unificado de recomendações definitivas, o que torna a prática clínica extremamente variável. Objetivos Avaliar o uso de terapia elástica compressiva por 7 dias após flebectomia. Métodos Cento e quatro membros inferiores, classificados como CEAP C1 e C2, foram randomizados em dois grupos: grupo de intervenção (64 membros) - uso de meia elástica por 24 horas após a cirurgia - e grupo controle (40 membros) - uso de curativo convencional por 7 dias após a cirurgia. A resposta clínica foi comparada por meio de análise da evolução dos sintomas, de hematoma e do volume dos membros antes e depois da cirurgia. Resultados Os pacientes submetidos a terapia compressiva elástica apresentaram melhora significativa na dor (mediana 1,0 vs. 1,5; p=0,0320) e no volume dos membros (média 43,7 vs. 99,8; p=0,0071) em comparação ao grupo controle. Conclusões O emprego da terapia compressiva elástica por 7 dias após flebectomia mostrou-se efetivo na melhora da dor e do volume dos membros inferiores.

Influence of the use of compression stockings on physiological, perceptual, and affective responses during running in recreational runners / Influência do uso de meias de compressão nas respostas fisiológicas, perceptuais e afetivas durante a corridas em corridores recreacionais

Este estudo objetivou comparar a influência do uso de polainas de compressão nas respostas fisiológicas, perceptuais e afetivas durante a corrida em corredores recreacionais. Dez corredores recreacionais (31,5 ± 9,7 anos) participaram deste estudo. Todos os sujeitos completaram três visitas ao laboratório: (a) familiarização e teste incremental até a exaustão (b) duas sessões de exercícios realizadas em dias diferentes. Cada sessão envolveu o mesmo protocolo de exercícios (20 minutos continuamente a uma intensidade de 80% da velocidade máxima da esteira a lcançada no teste incremental até a exaustão), com ou sem o uso de meias de compressão. A Felt Arousal Scale (FAS), Feeling Scale (FS), percepção subjetiva de esforço (PSE), o consumo de oxigênio (VO2) e a frequência cardíaca (FC) foram registradas durante cada sessão experimental. Os resultados não mostraram diferenças entre as condições fisiológicas (% VO2máx: 88,1 ± 8,3 vs 87,1 ± 11,32; % HR: 91,8 ± 2,8 vs 90,8 ± 3,2), e as respostas perceptuais (PSE: 6,4 ± 1,2 vs 6,2 ± 1,4) e afetivas (FS: 0,35 ± 2,4 vs 0,37 ± 2,3; FAS: 4,3 ± 0,7 vs 4,3 ± 1,1) durante cada sessão de exercício. Os resultados do presente estudo indicam que o uso de polainas de compressão não promove benefícios fisiológicos, perceptuais e afetivas durante a corrida em corredores recreacionais.(AU)

This study aimed to compare the influence of wearing compression stockings on physiological, perceptual, and affective respon ses during running in recreational runners. Ten recreational runners (31.5 ± 9.7 years) participated in this study. All subjects completed three visits to the lab: (a) familiarization and incremental test until exhaustion (b) two exercise sessions conducted on different days. Each session involved the same exercise protocol (20 min continuously at an intensity of 80% of the maximum treadmill speed achieved in the incremental test until exhaustion), with or without the use of compression stockings. The Felt Arousal Scale (FAS), Feeling Scale (FS), Rating of Perceived Exertion (RPE), oxygen consumption (VO2), and heart rate (HR) were recorded during each experimental session. Results showed no differ ences between the conditions of physiological (% VO2máx: 88.1 ± 8.3 vs 87.1 ± 11.32; % HR: 91.8 ± 2.8 vs 90.8 ± 3.2), perceptual (RPE: 6.4 ± 1.2 vs 6.2 ± 1.4) and affective (FS: 0.35 ± 2.4 vs 0.37 ± 2.3; FAS: 4.3 ± 0.7 vs 4.3 ± 1.1) responses during each exercise sessio n. The results of the present study suggest that wearing of compression stockings does not promote physiological, perceptual, and affective benefits during running of recreational runners.(AU)

Insuficiência venosa crônica e uso de meia elástica de compressão graduada: uma análise sobre a adesão ao tratamento em pacientes do SUS / Chronic venous insufficiency and graduated compression stockings: analysis of public health system patients' adherence to treatment

Resumo Contexto A insuficiência venosa crônica é uma doença de alta prevalência mundial, podendo chegar a até 80% da população. Sua incidência aumenta com a idade e é mais frequente no sexo feminino. Das opções terapêuticas, destaca-se a terapia compressiva, sendo a principal o uso de meia elástica de compressão graduada, considerado o tratamento básico para a insuficiência venosa crônica independentemente da classificação clínica do paciente. Na prática clínica, o resultado da terapia é prejudicado pela não adesão ao uso da meia. Objetivos Avaliar a taxa de adesão ao uso da meia elástica de compressão graduada, assim como compreender a problemática da não aderência ao tratamento. Métodos Estudo observacional transversal, realizado entre junho de 2017 até janeiro de 2019, mediante aplicação de questionário aos pacientes em ambulatório de cirurgia vascular do Sistema Único de Saúde (SUS), em um hospital-escola, em Curitiba, no estado do Paraná (PR). Os dados foram analisados com o programa computacional IBM SPSS Statistics v.20.0. Resultados Foram analisados 240 pacientes. A média de idade foi de 57,5±12,9 (22-86); 84,2% eram do sexo feminino. Do total de pacientes analisados, 106 (44,2%) não aderiram ao uso das meias. As justificativas para o não uso foram: questão financeira, dor, desconhecimento da necessidade, calor e outras. Conclusões A taxa de adesão encontrada no presente estudo foi de 55,8%, e o principal motivo para o não uso foi a questão financeira.

Abstract Background Chronic venous insufficiency (CVI) is a pathology of great importance due to its high worldwide prevalence, affecting up to 80% of the population. Its incidence increases with age and is more frequent in females. One of the most important treatment options is compression therapy and the main method employed is wearing graduated compression stockings, which is considered the basic treatment for CVI regardless of the patient's clinical classification. In clinical practice, treatment outcomes are impaired by patients not wearing the stockings properly. Objectives To analyze the rate of adherence to wearing graduated compression stockings and to understand the problem of treatment non-adherence. Methods Cross-sectional observational study conducted from June 2017 to January 2019, based on administration of questionnaires to patients at a SUS vascular surgery clinic at a teaching hospital, in Curitiba, PR, Brazil. Data were analyzed using the IBM SPSS Statistics v.20.0 computer program. Results 240 patients were analyzed. Mean age was 57.5 ± 12.9 (22 - 86) and 84.2% of the sample were female. 106 of the 240 patients analyzed (44.2%) were non-adherent with wearing compression stockings. Reasons for not wearing the stockings were: financial; pain; ignorance of the need to wear them; heat; and others. Conclusions The adherence rate observed in the present study was 55.8% and the most prevalent reason for not wearing stockings was financial.

Avaliação da efetividade do uso de meias de compressão na prevenção do edema ocupacional em cabeleireiras / Evaluation of the effectiveness of wearing compression stockings for prevention of occupational edema in hairdressers

Resumo Contexto O edema ocupacional (EO) de membros inferiores (MMII) é um importante fator de queda na qualidade de vida, e a sua prevenção impõe a prescrição de medidas profiláticas, como o uso de meias de compressão (MCs). Objetivos Avaliar a efetividade das MCs na prevenção do EO e a sua repercussão na qualidade de vida de cabeleireiras. Métodos Este ensaio clínico realizou medidas de tornozelo e panturrilha de 38 cabeleireiras sem doença venosa no início e no final da jornada de trabalho em um momento sem e em outro usando MCs. Também responderam um questionário sobre sintomas e qualidade de vida em doença venosa. Resultados Os valores do ponto B foram de 21,1±2,2 cm no momento inicial sem meias, 22,1±2,3 cm no momento final sem meias (p = 0,0001 em relação ao inicial sem meias), e 21,2±2,1 cm no momento final com meias (p = 0,0001 em relação ao final sem meias). Não foi significante a diferença entre os valores médios do ponto B inicial sem meias e final com meias (p=0,324), ou seja, não houve formação de edema nos MMII ao final da jornada de trabalho em ortostatismo prolongado quando em uso de MCs. Pôde-se observar melhora da limitação sobre as atividades laborais (p = 0,0001), domésticas (p = 0,008) e de lazer ou sociais em pé (p = 0,0001). Conclusões As MCs são efetivas na prevenção do EO de MMII, e a atenuação de sintomas como dor e fadiga contribui diretamente para melhor qualidade de vida de cabeleireiras.

Abstract Background Occupational lower limb edema is an important factor in deterioration of quality of life. Prevention involves prescription of prophylactic measures, such as wearing compression stockings. Objectives To evaluate the effectiveness of compression stocking for prevention of occupational edema and its repercussions for the quality of life of hairdressers. Methods A clinical trial involving measurements of the ankles (point B) and calves (Point C) of 38 hairdressers without venous disease at the beginning and end of workdays spent wearing or not wearing compression stockings. Participants also answered a questionnaire about symptoms and quality of life in venous disease. Results Point B measurements were: 21.1 ± 2.2 cm in the morning without stockings; 22.1 ± 2.3 cm at the end of the day without stockings (p = 0.0001 compared to baseline without stockings); and 21.2 ± 2.1 cm at the end of the day wearing compression stockings (p = 0.0001 compared to the end of day not wearing compression stockings). The comparison between point B values for the start of the day without compression stockings and the end of the day with stockings (p = 0.324) was not significant, showing that there was no lower limb edema at the end of the working day when compression stockings were worn. Improvements were observed in ratings for limitations of work activities (p = 0.0001), domestic activities (p = 0.008) and leisure or social activities performed standing up(p = 0.0001). Conclusions Compression stockings are effective for preventing occupational lower limb edema and the attenuation of symptoms such as pain and fatigue directly contributes to better quality of life for hairdressers.

Literature Review on Prophylaxis of Deep Venous Thrombosis and Pulmonary Embolism

Background: Deep Venous Thrombosis (DVT) and subsequent Pulmonary Embolism (PE) are one of the mosteminent causes of preventable deaths in nosocomial settings. The prevalence is increasing and they have variableclinical presentations encountered in community settings as well as hospitalized patients requiring timely andobligatory prophylaxis. Objective: This study aims to review prophylactic measures for deep venousthrombosis/pulmonary embolism highlighting implemented pharmacologic and mechanical interventions, newerand yet investigational techniques such as neuromuscular electrical stimulation towards reducing prevalence ofvenous thromboembolism. Materials and Methods: A review of relevant articles published between the years of2000 to 2019 in English language was done using the databases of PubMed Pico, Google Scholar and Google,using the predetermined keywords. Conclusion: Venous thromboembolism prevalence is increasing and amongthe various available methods for thromboprophylaxis, pharmacologic approach is the most superior whichinvolves making use of either unfractioned or low molecular weight heparin although the most efficacious is lowmolecular weight heparin as evidenced by several meta-analyses. Anticoagulants have numerous side effectsleading to limitations of their use and in such situations, mechanical methods such as intermittent pneumaticcompression (most effective), graduated compression stockings, and venous foot pump scan can be used. Incircumstances where both medicines and mechanical approach become impractical, neuromuscular electricalstimulation can be implemented even though additional research is required to further elucidate its efficacy andimplications.

Effects of antithrombotic pressure pump combined with graduated compression stocking on the incidence of lower extremity deep venous thrombosis in the postoperative breast cancer patients / 中国实用护理杂志

Objective To investigate the prevention effects of antithrombotic pressure pump combined with graduated compression stockings (GCS) on incidence of postoperative lower extremity deep venous thrombosis (LEDVT) in breast cancer patients. Methods A total of 363 cases of breast cancer patients after operation were divided into routine care group (124 cases) according to the method of random number table, pressure group (127 cases) and combined treatment group (112 cases). The routine care group received conventional LEDVT ankle pump exercises. The pressure group used GCS besides the routine intervention. The combined group received GCS and antithrombotic pressure pump besides the routine intervention. Then the levels of thrombosis markers, D-dimers,platelets, and incidences of LEDVT were examined in the three groups. Results Before operation, no significant differences between the levels of prothrombin time (PT), activated partial prothrombin time (APTT), thrombin time (TT), fibrinogen, plasma D-dimer and platelets (P>0.05). After operation, the levels of PT, APTT, TT, fibrinogen, plasma D-dimer and platelets in three groups were (10.22 ± 0.76) s, (27.24 ± 3.68) s, (14.60 ± 0.88) s, (2.94 ± 0.59) mg/L, (0.31 ± 0.21) mg/L, (288.48 ± 71.29) × 109/L, (10.73 ± 0.79) s, (27.35 ± 2.54) s, (14.71± 1.76) s, (4.12±1.09) mg/L, (0.46±0.38) mg/L, (284.26±70.98) ×109/L and (11.11±0.64) s、(28.52± 2.74) s, (14.33± 1.02) s, (4.42±1.20) mg/L, (0.35±0.33) mg/L, (258.79±62.35) ×109/L, respectively. There was significant difference among these groups (F=5.71-87.31, P<0.01). The differences on PT, APTT, fibrinogen and D-dimers between combined treatment group and routine care group were statistically significant (P<0.05). The differences on PT, fibrinogen and platelets between combined treatment group and pressure group were statistically significant (P<0.05). The differences on PT, APTT, fibrinogen and D-dimers between routine care group and pressure group were statistically significant (P<0.05). Through one months of follow-up, the incidence of LEDVT in routine care group, pressure group and combined treatment group were 12.10％(15/124),3.15％(4/127),0.89％(1/112), respectively. There was significant difference among these groups (χ2=16.279,P<0.01). Conclusions The application of antithrombotic pressure pump combined with GCS significantly improves the postoperative hypercoagulable states in breast cancer patients. The combined treatment reduces the incidence of LEDVT without bleeding risk. Therefore, antithrombotic pressure pump combined with GCS is recommended for clinical use in the postoperative breast cancer patients.

Compression stockings reduce the incidence of hypotension but not that of cerebral desaturation events in the beach-chair position: a randomized controlled trial / 대한마취과학회지

BACKGROUND: The beach-chair position (BCP) results in decreases in venous return, cardiac output, and cerebral perfusion pressure. In this randomized, prospective study, we investigated whether applying thigh-high compression stockings affected the maintenance of regional cerebral tissue oxygen saturation (rSO2) in the BCP. METHODS: Patients undergoing orthopedic surgery in the BCP under general anesthesia were included and assigned randomly to the control or the compression stocking group. Appropriately sized thigh-high compression stockings were applied to the patients in the stockings group. All patients were tilted, up to 45°, throughout the operation. Non-invasive blood pressure, invasive arterial blood pressure zeroed at the external auditory meatus, and rSO2 were recorded. RESULTS: Data were analyzed from 19 patients per group. In the BCP, the values of rSO2 and blood pressure decreased significantly compared with those at baseline, with no significant difference between the groups. The incidences of cerebral desaturation events (CDEs) were similar between the groups; however, that of hypotension was significantly lower in the compression stocking group. During 36 CDEs, the levels of rSO2 and blood pressure decreased significantly compared with those at baseline in both groups. No significant correlation was found between rSO2 and blood pressure. CONCLUSIONS: Thigh-high compression stockings reduced the incidence of hypotension but not that of CDEs. Our results suggest that other factors, beyond hypotension itself, contribute to CDEs and in other words, efforts just to reduce the incidence of hypotension may not mainly contribute to a reduction of CDEs occurrence in the BCP under general anesthesia.

Quality of life in chronic venous patients who do or do not wear compressive stockings / Qualidade de vida em doentes venosos crônicos usuários e não usuários de meias elásticas

Wearing elastic compression stockings is of considerable significance for patients with chronic venous disease (CVD), since their physiological effect is to improve venous hemodynamic parameters, making them a good treatment option that can impact on patients' quality of life. OBJECTIVE: To assess quality of life in patients with chronic venous disease who do or do not wear elastic stockings. METHODS: This was a cross-sectional observational study assessing a sample of 50 CVD patients of both sexes, divided into two groups, one who wear elastic stockings and another who do not. Primary variables were the domains of the SF-36 (Medical Outcomes Study Short-form 36) and AVVQ (Aberdeen Varicose Veins Questionnaire) and secondary variables were: age; sex; physical activity; educational level; profession; wearing elastic stockings (frequency, pressure and type); elevation of lower limbs; itching and CEAP classification. The SF-36 and AVVQ quality of life questionnaires were administered to patients. Statistical significance was set at p<0.05. RESULTS: Wearing elastic stockings proved beneficial for the quality of life of people with chronic venous disease. For the AVVQ disease-specific questionnaire the greatest improvements were in overall score (p=0.0028) and the extent of varicosity domain (p=0.000). The SF-36 domains role emotional (p=0.017) and functional capacity (p=0.000) both improved. CONCLUSIONS: Wearing elastic stockings is an effective treatment for CVD that improves disease-specific quality of life and also leads to improvements in general quality of life...

O uso de Meias Elásticas Compressivas em pacientes com doença venosa crônica (DVC) é de grande significância, na medida em que reflete, na sua atuação fisiológica, melhora nos padrões hemodinâmicos venosos, configurando-se como boa opção terapêutica e podendo interferir na qualidade de vida do indivíduo. OBJETIVO: Avaliar a qualidade de vida de indivíduos com doença venosa crônica usuários e não usuários de meias elásticas. MÉTODOS: Trata-se de um estudo observacional de corte transversal, no qual foram avaliados 50 pacientes de ambos os sexos, com DVC, compondo dois grupos: um de usuários e o outro, de não usuários de meias elásticas. Teve, como variáveis primárias, os domínios dos questionários SF-36 (Medical Outcomes Study Short-form 36) e AVVQ (Aberdeen Varicose Veins Questionnaire); constituíram as variáveis secundárias: idade; sexo; atividade física; escolaridade; profissão; uso de meias elásticas (frequência de uso, pressão e tipo); elevação de membros inferiores; presença de prurido, e CEAP. Os pacientes responderam aos questionários de qualidade de vida SF-36 e AVVQ. A significância estatística considerada foi p<0,05. RESULTADOS: A utilização da meia elástica mostrou benefício na qualidade de vida dos indivíduos portadores de doença venosa crônica. O aspecto mais favorecido no questionário específico AVVQ relacionou-se à sua pontuação total (p=0,0028) e ao domínio Extensão da varicosidade (p=0,000). Já quanto ao SF-36, podem-se apontar o aspecto emocional (p=0,017) e a capacidade funcional (p=0,000). CONCLUSÃO: O uso de meias elásticas apresenta-se como uma terapêutica eficaz na DVC, melhorando a qualidade de vida específica e havendo, também, ganho na qualidade de vida geral...

Non-pharmacological Prophylaxis of Venous Thromboembolism in Acutely Ill Medical Patients.

Venous thromboembolism (VTE) represents one of the leading causes of mortality and morbidity in acutely ill medical patients. VTE prophylaxis can be assured by pharmacological strategies and, when contraindicated, by non pharmacological measures, such as early mobilization, graduated compression stockings (GCS), intermittent pneumatic compression (IPC) or inferior vena caval filters. Literature evidence on non pharmacological VTE prophylaxis lacks and guidelines are not standardized for hospitalized ill medical patients. Much recently randomized clinical trials in patients with stroke and other medical diseases, seem to increase doubts and reduce certainties in this context. In this review we provide information about non pharmacological thromboprophylaxis in acutely hospitalized ill medical patients.

Compression stockings to prevent post-thrombotic syndrome after giant surgery in department of orthopaedics: A Meta analysis / 中国实用护理杂志

Objective To systematically evaluate the effects of compression stockings for preventing post-thrombotic syndrome after giant surgery in department of orthopaedics.Methods Randomized controlled trials about compression stockings were searched and analyzed no matter written in Chinese or English.The effects of compression stockings is determined by Meta-analysis with Review Manager 5.0.Results 4 papers were included in this research,among which,one was domestic,and another three were abroad.Heterogeneity was small when the data was merged,which suggested that compression stocking for preventing post-thrombotic syndrome was effective.Conclusions Compression stockings can be safely used to prevent post-thrombotic syndrome after giant surgery in department of orthopaedics.

Effects of wearing graduated elastic compression stockings on arterial stiffness / 体力科学

This study aimed to determine the effects of wearing graduated elastic compression stockings (GCSs) on arterial stiffness. The study included 10 healthy men who were randomly assigned to undergo trials with and without GCSs on separate days. Baseline measurements of brachial-ankle pulse wave velocity (baPWV), heart rate, and brachial blood pressure (BP) were obtained in the supine position after the subjects had rested for 20 min without GCSs. The order of the trials (with or without GCSs) was set randomly. During both trials, data for these parameters were collected with the subjects in the supine position, after they had rested for 20 min. After both trials, the brachial BP did not significantly change from the baseline values. baPWV significantly decreased after trials with GCSs (from 1153.0 ± 123.4 to 1078.1 ± 134.3 cm/s, P < 0.05), but no significant difference was observed after trials without GCSs (from 1125.2 ± 118.7 to 1134.5 ± 100.9 cm/s). In addition, changes in volume after trials with GCSs (-74.9 ± 35.3 cm/s) were significantly lower than those after trials without GCSs (+9.3 ± 36.7 cm/s, P < 0.05). baPWV significantly decreased during supine rest on wearing GCSs. This decrease in baPWV was possibly caused by a decrease in arterial stiffness itself and/or a decrease in vascular transmural pressure that may have been due to increase in external pressure on the vasculature.

Application of gradient elastic compression stockings in patients undergoing laparoscopic cholecystectomy / 中国实用护理杂志

Objective To explore the feasibility and effectiveness of gradient elastic compression stockings in prevention of venous stasis in patients undergoing laparoscopic cholecystectomy(LC). Methods 160 LC patients were randomized into the experimental group(75 cases)and the control group (85 cases).Routine nursing care and treatment were performed in both groups,and gradient elastic compression stockings were used in the experimental group.Venous pressure was measured in four different periods (T1,T2,T3,T4). Results The venous pressure in T2,T3 and T4 in the experimental group was significantly lower than that in the control group. Conclusions Use of gradient elastic compression stockings is effective and feasible in preventing LC-induced venous stasis.

Effect of Anti-embolism Stocking on Intrasession Hemodynamic Variables in Hemodialysis Patients / 대한신장학회지

PURPOSE: There is no data about the effect of anti-embolism stockings on intrasession hemodynamics in end stage renal disease patients on hemodialysis (HD). We investigated whether it affects the hemodynamic changes during HD or not. METHODS: We performed 2 HD sessions, before (stocking negative, SN) and after (stocking positive, SP) putting on thigh-high anti-embolism stockings in 11 ESRD patients on HD. In each session, cardiac output (CO), stroke volume (SV), central blood volume (CBV), and peripheral resistance (PR) were measured by ultrasound velocity dilution method at 1 and 3 hours of HD. Ultrafiltration (UF) amount was matched during study. Hemodynamic variables were compared between SN and SP. RESULTS: Mean ages were 51+/-14 years, female was 8, diabetes mellitus was 4, and duration of HD was 56.9+/-28.9 months. There were no differences in pre- and post-HD SBP and DBP, UF amount at 1 hr and 3 hr of HD, and total UF amount between SN and SP. At 1 hr of HD, CBV was greater in SP than in SN (0.85+/-0.32 L vs. 0.93+/-0.32 L, p=0.003). CO (5.56+/-1.22 L/min vs. 5.14+/-1.35 L/min, p=0.075) and SV (73.77+/-19.11 mL vs. 68.95+/-22.21 mL, p=0.05) tended to be increased in SP than in SN. However, there were no differences in TPR between 2 groups. At 3 hr of HD, there were no differences in all hemodynamic variables bewteen SP and SN. CONCLUSION: At early phase of HD, anti-embolism stockings seem to increase CBV, but this effect seems to be attenuated at later phase.

The use of enoxaparin to prevent venous thromboembolism in patients undergoing radical retropubic prostatectomy: feasibility and utility

OBJECTIVE: To assess the utility of enoxaparin in prevention of venous thromboembolism (VTE) in men poorly compliant with pneumatic compression stockings (PCS) in the immediate postoperative period after a radical retropubic prostatectomy (RP). MATERIALS AND METHODS: This retrospective study included 47 men who underwent RP at an inner-city tertiary care hospital. All patients were started on enoxaparin 40 mg subcutaneously 6-8 hours postoperatively and daily while hospitalized. Preoperative, operative, and postoperative data were collected and analyzed. Median follow-up was 18 months. RESULTS: Median patient age was 64 ± 7 years, median prostate-specific antigen level was 4.9 ng/mL and median prostate biopsy-determined Gleason score was 6. Forty-one men (87 percent) underwent a pelvic lymph node dissection. Median operative time was 181 minutes (range 164-450 minutes). Median estimated blood loss was 700 mL. Approximately 36 percent of the men wore PCS the recommended > 19 hours/day. On average PCS were worn 10.3 ± 7.5 hours/day. Postoperative complications were not increased in this cohort. Two patients developed pulmonary embolism requiring long-term anticoagulation. There were no mortalities. CONCLUSIONS: In men non-compliant with PCS, initiation of enoxaparin in the immediate postoperative setting was well-tolerated and maintained a low (4 percent) rate of VTE. Thus, enoxaparin may be useful in adjunct with PCS in these patients.

The Effect of SCD Response Compression System on Coagulation and Fibrinolysis using Thromboelastography in Patients Undergoing Gastrectomy; a Comparison with Elastic Stocking / 대한마취과학회지

BACKGROUND: Among various measures to prevent deep venous thrombosis (DVT) in surgical patients, intermittent pneumatic compression of the legs is known to be effective without increasing the risk of bleeding. In this study, the coagulation/ fibrinolysis profile in patients undergoing gastrectomy with SCD Response Compression System, which detects individual venous refill time, was compared to that with elastic stocking using thromboelastography (TEG). METHODS: Fifty-eight ASA class I-II patients undergoing gastrectomy were randomized into two groups. Patients in ES group (n = 29) were treated with elastic stocking and patients in SCD group (n = 29) were treated with SCD Response Compression System. TEG analysis and traditional coagulation tests were performed on arrival in the operating room, after surgery in the postanesthetic care unit and on the morning of postoperative day 1. RESULTS: There was no significant difference in laboratory data between the two groups. Laboratory data at all time points were within normal limit in all patients. There was no significant difference in TEG data between the two groups. No evidence of a postoperative clinical coagulopathy (DVT or pulmonary embolism) was observed on routine history and physical examinations in any patient during hospitalization. CONCLUSIONS: The effectiveness of SCD Response Compression System in patients undergoing major abdominal surgery on coagulation/fibrinolysis system was similar to that of elastic stocking during perioperative period.