Assuntos
Amputados/reabilitação , Artroplastia de Quadril/reabilitação , Osteoartrite do Quadril/epidemiologia , Adulto , Idoso , Comorbidade , Ectromelia/epidemiologia , Ectromelia/cirurgia , Feminino , Humanos , Perna (Membro)/cirurgia , Desigualdade de Membros Inferiores/epidemiologia , Desigualdade de Membros Inferiores/cirurgia , Masculino , Doenças Vasculares Periféricas/epidemiologia , Doenças Vasculares Periféricas/cirurgiaRESUMO
Intraoperative, unfractionated heparin, administered intravenously before the femoral work, has demonstrated to be effective in reducing the strong thrombotic stimulus that occurs during total hip arthroplasty (THA) surgery. This randomized, double-blind, prospective study included only THA patients with significant comorbidities predisposing them to deep vein thrombosis (DVT). The 2 groups consisted of study patients who received a single dose of intravenous, intraoperative, unfractionated heparin and control patients who received a single dose of intravenous, intraoperative saline. Magnetic resonance venography was used as the DVT diagnostic tool. The overall prevalence of proximal femoral vein clots was 2.2% (3 of 134), whereas pelvic thrombosis was detected in 10.4% (14 of 134). This study demonstrated that pelvic thrombi may form following THA and that a single dose of intraoperative heparin does not prevent their formation, but may be effective at preventing ipsilateral femoral thrombi. This study strongly supports a multimodal approach to DVT prophylaxis following THA.
Assuntos
Anticoagulantes/administração & dosagem , Artroplastia de Quadril , Heparina/administração & dosagem , Imageamento por Ressonância Magnética , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Método Duplo-Cego , Feminino , Humanos , Incidência , Cuidados Intraoperatórios , Masculino , Pessoa de Meia-Idade , Flebografia/métodos , Estudos Prospectivos , Trombose Venosa/epidemiologiaRESUMO
A prospective study was performed to assess compliance with using a pneumatic foot compression device for venous thrombosis prophylaxis after total knee arthroplasty. One hundred patients received the PlexiPulse pneumatic compression device after unilateral total knee arthroplasty. Patients were observed postoperatively by the nurses on their floor and by 2 impartial research assistants. Total time the patient spent wearing the device (as observed) was termed total compliance. Actual compliance was calculated by subtracting unusable time from total compliance. A survey was also issued to both patients and nurses to evaluate the device regarding comfort, ease of use, and effectiveness. Overall, actual patient compliance was 90.1%. Patients responded favorably to the device in terms of comfort and ease of application and removal. Nurses rated the PlexiPulse device highly when asked to compare it with other pneumatic compression devices they had used before.
