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  4. Non-pharmacological Methods of Deep Vein Thrombosis Prophylaxis in Orthopaedic Wards

Non-pharmacological Methods of Deep Vein Thrombosis Prophylaxis in Orthopaedic Wards

Cureus, 2024 · DOI: 10.7759/cureus.73255 · Published: November 7, 2024

Medical ImagingOrthopedicsRehabilitation

Simple Explanation

Deep vein thrombosis (DVT) is a post-operative complication that surgeons try to prevent. Common preventatives are blood thinners but these can increase post-operative bleeding. This editorial discusses using basic physiotherapy as a non-drug method to prevent DVT. The physiotherapy involves simple exercises like static hamstring, quadriceps exercises and ankle pumps, done to prevent blood from pooling in the legs, which is thought to help prevent DVT. This method is generally applicable, cost-effective, and doesn't cause adverse reactions, but it has limitations in patients with ankle fractures, polytrauma, spinal cord injury, or neurological injury.

Study Duration
Not specified
Participants
Not specified
Evidence Level
Not specified

Key Findings

  • 1
    Basic physiotherapy exercises, such as ankle pumps, static hamstring, and quadriceps exercises, initiated early can prevent DVT by preventing blood pooling in the lower limbs and increasing venous return.
  • 2
    This non-pharmacological method does not affect the coagulation cascade, reducing the risk of bleeding or drain output in post-operative patients, and it lowers the cost burden of hospitalization by avoiding costly drugs and mechanical devices.
  • 3
    The method's advantages include cost benefits, applicability in most patients, minimal adverse effects, and an observed reduction in DVT incidence, though it has limitations in patients with ankle fractures, spinal cord injuries, and intubated cases.

Research Summary

Deep vein thrombosis (DVT) is a significant post-operative risk, especially in major surgeries. While pharmacological prophylaxis is common, it may be contraindicated due to bleeding risks. This editorial explores non-pharmacological methods, specifically basic physiotherapy. The described approach involves initiating basic physiotherapy like static hamstring, quadriceps exercises, and ankle pumps to prevent blood pooling in the lower limbs, thereby hypothesized to prevent DVT. This method offers benefits like universal applicability, cost-effectiveness, and minimal adverse reactions, although it has limitations in specific patient populations. The authors advocate for its use and plan further studies to document its efficacy.

Practical Implications

Early Physiotherapy Implementation

Encourage early initiation of basic physiotherapy exercises like ankle pumps and static muscle contractions in post-operative orthopaedic patients.

Cost-Effective DVT Prevention

Consider basic physiotherapy as a cost-effective alternative or adjunct to pharmacological prophylaxis for DVT in suitable patients.

Individualized Prophylaxis Strategy

Assess patient-specific factors and contraindications to tailor DVT prophylaxis strategies, integrating non-pharmacological methods where appropriate.

Study Limitations

  • 1
    Limitations include in patients with lower limb ankle fractures
  • 2
    polytrauma patients who are intubated
  • 3
    spinal cord injury patients with power loss and patients with neurological injury

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