Orthopedic Articles on Deep Venous Thrombus Prevention
Using Sequential Compression Devices (SCDs) is not a new concept, and recent studies show that SCDs may provide as much benefit in clot prevention as using blood thinners, e.g., Lovenox, heparin, or oral agents. Historically, routine preventative management for the prevention of DVT (Deep Venous Thrombosis) and PE (pulmonary Embolism) included only costly injectable and oral blood thinners. DVT and PE are well known complications after any surgical procedure (especially orthopedic cases involving bones and joints) or prolonged periods of rest (recovery from surgery, illness, or travel). Below is a summary of some recent articles.
A recent research paper was published in Orthopedics Today (December 2015) and presented at the CCJR (Current Concepts in Joint Replacement) Winter Meeting in Florida. This study included 3,143 patients undergoing joint replacement surgery and concluded there was no difference between using the SCD compression device and blood thinners in the prevention of post-surgical clots. In fact, patients on blood thinners experienced greater complication rates of blood loss and wound drainage.
The Journal of Bone and Joint Surgery published an article in February 2014 about the use of a mobile compression device for blood clot (thrombosis) prevention following major orthopedic procedures. Over 3000 patients participated in the study. The use of the mobile sequential compression device for patients undergoing lower extremity joint replacement provided the same level of clot prevention as compared with current blood thinners. Sequential compression devices prevent DVT/PE when used appropriately with simple aspirin therapy. Again, the major benefit compared to more traditional aggressive blood thinner medications is a significantly lower risk of bleeding, wound complications, and readmission due to complications of anticoagulants.
The Journal of Bone and Joint Surgery, March 2010; Thrombosis Prevention after Total Hip Arthroplasty. Over 400 patients took part in the study which concluded that there was little if any significant difference in the efficacy of heparin (injectable blood thinner) and SCDs in the prevention of DVT/PE after hip replacement surgery. Patients using SCDs had no device related bleeding complications while those on heparin had bleeding and wound complications due to therapy.
Current data and trends are strongly directing management of DVT/PE prevention toward mechanical treatment using SCDs for both surgical and non-surgical situations such as travel, illness, and other causes of immobility.