PHRM 111 Lecture Notes - Lecture 5: Intermittent Pneumatic Compression, Compression Stockings, Low Molecular Weight Heparin
Document Summary
General surgery involving the abdominal contents (eg. bowel resection, appendectomy) Orthopedic surgery involving the musculoskeletal system especially hip and knee surgeries. Surgery causes blood vessel wall injury activation of clotting cascade. Surgical patients often have multiple additional risk factors (e. g. age, cancer, obesity) Caprini score : an approach to help stratify vte risk in general surgery patients. Validated in retrospective studies involving a number of non-orthopedic surgeries. Mechanical prophylaxis while in hospital, preferably with intermittent pneumatic compression. Lmwh, lduh or fondaparinux combined with intermittent pneumatic compression devices (ipc) or graduated compression stockings (gcs) while in hospital. Moderate or high risk patients who are also at high risk of bleeding. Start 0-2 hours before or 0-12 hours after the start of surgery (or next day if bleeding a concern) Moderate and high risk: continue until hospital discharge. High risk and major cancer surgery : continue for 28 days post discharge with lmwh.
