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Low molecular weight heparin prophylaxis in day case surgery
J Shabbir1, P F Ridgway, W Shields
1Dept of Surgery, Wexford General Hospital, Wexford. Jshabbir@aol.com
Irish Journal of Medical Science
|February 23, 2007
Summary
The use of low molecular weight heparins (LMWH) in day case surgery varies widely, with many surgeons lacking confidence in protocol adherence. This highlights a need for standardized LMWH prophylaxis guidelines in short-stay procedures.
Area of Science:
- Surgical prophylaxis
- Pharmacology
- Venous thromboembolism prevention
Background:
- The efficacy and safety of low molecular weight heparins (LMWH) in day case and short-stay surgical settings remain largely uncharacterized.
- Current clinical practice regarding LMWH prophylaxis in these procedures is not well understood.
Purpose of the Study:
- To investigate and describe the current national utilization patterns of LMWH prophylaxis.
- Focus on specific day and short-stay surgical procedures.
Main Methods:
- A national survey was conducted using a standardized, anonymous postal questionnaire.
- Distributed to all consultant general surgeons in Ireland.
- Targeted operations included herniorraphy, anorectal procedures, varicose vein surgery, and laparoscopic cholecystectomy.
Main Results:
- A response rate of 68.3% was achieved from 82 surveyed surgeons.
- 54% reported having a protocol for LMWH administration in day case surgery, but 41% lacked confidence in protocol adherence.
- 59% stratified patients by individual risk; 13% reported post-day case venous thromboembolism (VTE).
Conclusions:
- The study reveals significant heterogeneity in LMWH administration practices for day case surgery.
- The absence of validated, published protocols necessitates the development of consensus guidelines.
- A standardized day case protocol for LMWH prophylaxis is proposed.
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