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05:52
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Comparing consensus guidelines on thromboprophylaxis in orthopedic surgery.
M C Struijk-Mulder1, H B Ettema, C C Verheyen
1Department of Orthopedic Surgery, Isala Clinics, Zwolle, the Netherlands.
Journal of Thrombosis and Haemostasis : JTH
|December 31, 2009
Summary
Guidelines for preventing venous thromboembolism (VTE) in orthopedic surgery vary significantly, even when based on the same evidence. Regular updates are crucial due to rapidly evolving research in thromboprophylaxis.
Area of Science:
- Orthopedic Surgery
- Thromboprophylaxis
- Evidence-Based Medicine
Background:
- Venous thromboembolism (VTE) prevention in orthopedic surgery lacks uniform guidelines.
- Existing guidelines present considerable variations in recommendations.
Purpose of the Study:
- To compare international and national guidelines for VTE prevention in orthopedic surgery.
- To analyze discrepancies in recommended thromboprophylactic regimens.
Main Methods:
- Systematic search of MEDLINE, Cochrane Library, and internet for VTE prevention guidelines.
- Comparative analysis of antithrombotic prophylaxis across various orthopedic procedures and immobilization methods.
Main Results:
- Eleven guidelines from nine countries and one international guideline were analyzed.
- Limited guidance exists for VTE prophylaxis post-plaster immobilization, arthroscopic surgery, and isolated lower extremity trauma.
- Disagreements noted on aspirin use, mechanical prophylaxis, and vitamin K antagonist use after major hip/knee surgery.
Conclusions:
- Divergent VTE prophylaxis recommendations stem from the same literature base.
- Lack of consensus on endpoints like asymptomatic deep vein thrombosis (DVT) hinders agreement.
- Guidelines require frequent review and updates to reflect evolving evidence in thromboprophylaxis.
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