Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Hip
Abstract number: 23664
ROUTINE USE OF ANTICOAGULANT CHEMOPROPHYLAXIS IN JOINT
REPLACEMENT ARTHROPLASTY - DOUBLE OR SINGLE EDGED DEADLY
WEAPON? TIME TO WAKE UP!
Chandra YADAV, Ashok KUMAR, Sameer NARANJE, Shah KHAN
All India Institute of Medical Sciences, Delhi (INDIA)
Background: To evaluate the routine prophylactic use of low molecular weight
heparin (LMH) in patients undergoing joint replacements. Material & Methods: A
prospective cohort of 200 patients undergoing hip or knee replacements who did not
receive any prophylactic LMH and a retrospective cohort of 200 patients who
received routine prophylactic LMH were included in two groups A & B respectively.
Colour Doppler was done 100 patients from group A in the preoperative period and
on 4th postoperative day. Results: No symptomatic DVT was found in any patient.
Doppler ultrasound showed DVT in two of 100 cases from group A however these
two patients had no signs or symptoms of thromboembolism. Out of 200 cases of
group B, post operative excessive bleed loss in wound drain was seen in 24 (12%)
cases, wound hematoma and surrounding tissue staining were seen in 52 cases
(26%), postoperative infection was seen in 10 cases (5%), epidural bleeding was
seen in 4 cases (2%) and nonfatal intracranial bleeding was seen in one patient
(0.5%). From group A only two patients had post operative infection (2 %) and no
other significant complications were seen in this group. Conclusion: Routine
prophylactic use of LMH in patients with joint replacements is associated with
transfusion of more units of blood, drainage of persistent wound hematoma, delayed
wound healing and wound infection. Therapy is expensive; it increases hospital stay
and does not change the incidence rate of fatal pulmonary embolism.
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