Low dose dextran 40 in reconstructive hip surgery patients

Preoperative and postoperative bilateral lower extremity venography was used to evaluate the efficacy of low dose dextran 40 in prophylaxis of deep venous thrombosis in reconstructive hip surgery patients. Patients were given dextran 40 at 50 cc/hr, with 250 cc given perioperatively and 500 cc given on postoperative days two and four. Five of 227 patients had positive venograms preoperatively. Of these 227 patients, 179 met protocol requirements and had venography postoperatively. Venous thrombosis occurred in 33 (18%) of those studied postoperatively. Of these, 11 were calf clots without extension to the popliteal region. Therefore, there were 22 patients (12%) with femoral or popliteal involvement overall. There were two deaths, neither of which was secondary to pulmonary embolus or a complication of dextran. There were two wound complications. These results suggest that low dose dextran 40 administered as indicated is a safe and efficacious means of deep venous thrombosis prophylaxis in reconstructive hip surgery patients.