Prophylaxis of postoperative venous thrombosis in a controlled trial comparing dextran 70 and low-dose heparin

1980 ◽  
Vol 4 (2) ◽  
pp. 239-243 ◽  
Author(s):  
David Bergqvist ◽  
Torgil Hallböök
1977 ◽  
Author(s):  
D. Bergqvist ◽  
H.O. Efsing ◽  
T. Hallböök ◽  
T. Hedlund

The prophylactic effect of low dose heparin on postoperative thrombosis in general surgery is well established. Dextran 70 has been shown to reduce the frequency of fatal pulmonary embolism. The effect of these prophylactic methods in-hip surgery is debated. The aim of this study was to compare dextran 70, low dose heparin and no treatment in post-traumatic and elective hip surgery. The groups were separately randomized to either prophylaxis. In patients with hip fracture (75 patients) thrombosis was diagnosed with 125I-fibrinogen test. The same diagnostic method was used after elective hip arthroplasty according to Brunswik (96 patients). In the latter group screening for pulmonary embolism was made one week postoperatively with perfusion scintigraphy (Tc-labelled macroaggregated albumin) and x-ray; the diagnosis being based on the combination of a perfusion defect and normal x-ray. The frequency of thrombosis in patients with hip fracture was 67% in the control group, 67% in the low dose heparin group and 40% in the dextran 70 group. The corresponding frequencies for patients undergoing elective hip surgery were 50, 26 and 55%. Pulmonary embolism was seen in 38, 24 and 24% respectively (one fatal embolism in the control group). From this study it can be concluded that only dextran 70 lowers the frequency of thrombosis after hip fracture. Low dose heparin diminishes the frequency of thrombosis in elective hip surgery whereas the two prophylactic methods are equally effective in prophylaxis of pulmonary embolism.


1972 ◽  
Vol 10 (25) ◽  
pp. 100-100

Our article (November 10, p. 89) gave the basic NHS cost of a 7-day perioperative course (5000 i.u. 12-hourly) as 75 to 90p. MIMS gave the wrong price and in fact Weddel’s heparin costs the same as the other brands, and 75p. is the correct figure. It is worth noting that in the case of heparin, which is almost entirely used in hospitals, the actual cost is up to 25% less than the ‘basic NHS cost’, because most hospitals buy large quantities at special contract prices. The opposite is true for drugs dispensed by retail pharmacists, where the actual cost exceeds the basic NHS cost because it includes a dispensing fee and container allowance.


1988 ◽  
Vol 22 (2) ◽  
pp. 107-114 ◽  
Author(s):  
Andra J. Melamed ◽  
Jeanette Suarez

Deep venous thrombosis (DVT) is a significant problem in the postoperative course of high-risk patients. Risk factors that further predispose patients to DVT include obesity, age over 40 years, smoking, dehydration, and a prior history of thromboembolism. Diagnosis of DVT by physical examination and medical history is difficult; objective diagnostic techniques are often required. Considerable emphasis has been placed on the cost-effectiveness of implementing prophylactic measures in patients who are at high risk for developing DVT. Physical maneuvers attempt to reduce stasis and enhance venous return and pharmacologic approaches alter blood coagulability. The drug therapy used in preventing DVT consists of dextran, low-dose heparin, a combination of low-dose heparin and dihydroergotamine, and warfarin. Effective prophylactic regimens differ according to the type of patients at risk. Prophylactic therapy should be tailored according to the patient's disease and degree of risk.


2008 ◽  
Vol 22 (9) ◽  
pp. 1971-1976 ◽  
Author(s):  
O. Barkay ◽  
E. Niv ◽  
E. Santo ◽  
R. Bruck ◽  
A. Hallak ◽  
...  

1977 ◽  
Vol 53 (617) ◽  
pp. 130-133 ◽  
Author(s):  
H. M. Barber ◽  
E. J. Feil ◽  
C. S. Galasko ◽  
D. H. Edwards ◽  
R. A. Sutton ◽  
...  

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