[Weak evidence for the use of graduated elastic compression stockings by laparoscopic day surgery]. / Svag evidens for graduerede elastiske kompressionsstrømper ved laparoskopisk sammedagskirurgi.

Deep vein thrombosis and pulmonary embolism are well-known complications after surgery. Despite the widespread use of graduated elastic compression stockings as a mechanical prophylaxis method against thromboembolic complications, data supporting their use for patients under-going laparoscopic surgery for benign conditions are sparse. In this paper, we address the evidence for the effectiveness of the stockings as a method of prophylaxis in laparoscopic day surgery.

[Thrombo-prophylaxis in Danish surgical departments. Status 2005 and 25 years' development]. / Tromboseprofylakse på kirurgiske afdelinger i Danmark. Status 2005 og 25 ars udvikling.

OBJECTIVES: To assess Danish surgical departments' attitudes to and clinical guidelines on the use of perioperative thrombo-prophylaxis (TP). MATERIALS AND METHODS: Questionnaires regarding TP were sent to Danish departments which performed major surgery in 2005. The questionnaires contained questions regarding the use of TP routinely after clinical guidelines for both elective and acute surgery, indications for the use of TP, the type of TP and the duration of the TP treatment. The results are registered descriptively. The results are compared with five previously performed surveys from 1981-2000. RESULTS: In the five surveys from 1981 to 2000, 85%, 90%, 92%, 95%, 93% answered the questionnaire, in the present survey 88% answered. Since the beginning of these surveys, there has been a significant increase in the use of TP following clinical guidelines from approximately 50% in 1981 to 96% of the departments performing major surgery in 2005. In acute surgery we found a significant increase in the number of departments using TP following clinical guidelines from 43% in 2000 to 81% in 2005 (p<0.01 Fishers exact test). All departments that used TP employed low molecular weight heparin. The use of prolonged TP was sporadic. CONCLUSION: 30 years after the first evidence in favour of TP was published, 96% of surgical departments which perform major surgery use TP routinely based on international clinical recommendations. A large number of departments use TP in connection with acute surgery in comparison with previous surveys. A future task is more focus on the use of prolonged TP after major surgical procedures.

[The antithrombotic-treated patient]. / Den antitrombotisk behandlede patient.

Management of perioperative treatment with anticoagulants and antiplatelet drugs is a complex medical problem. Careful preoperative evaluation of the risk of bleeding and thromboembolism with and without of antithrombotic therapy is the key prerequisite to secure safe outcome of elective, invasive procedures performed on patients treated with antithrombotic agents. In emergency cases, knowledge of the pharmacokinetics and pharmacodynamics of antithrombotic drugs and of the effect of antidotes and blood-derived, recombinant, and other haemostatic products is important.

[The use of venous thromboprophylaxis in Danish medical departments. A questionnaire survey]. / Brugen af tromboseprofylakse på medicinske afdelinger i Danmark. En sporgeskemaundersogelse.

INTRODUCTION: Our goal was to investigate the use of venous thromboprophylaxis in Danish hospital departments of internal medicine, neurology and intensive care. MATERIALS AND METHODS: All 242 Danish departments/wards received a two-page survey form to complete. Two reminders were sent. RESULTS: Eighty-two percent responded. Ninety percent use thromboprophylaxis, but only 69% of intensive care wards, 36% of neurological wards, and 22% of internal medicine wards have established general guidelines for its use. There is no difference between hospitals in larger cities and those in smaller cities. The most usual indication was prolonged bed rest. DISCUSSION: Compared with the scientific documentation, the use of thromboprophylaxis in Danish medical wards must be considered insufficient.