Abstract
Venous Thromboembolism is a common complication following a hip replacement. Recently the pulmonary embolism prevention study was published. It reported that aspirin decreased the fatal pulmonary embolism rate in patients admitted with a fracture neck of femur. In addition new products (synthetic factor X inhibitor -Fondaparinux, and a direct thrombin inhibiter-Desirudin) have been reported to be more effective than low molecular weight heparin in preventing asymptomatic deep vein thrombosis. We felt it was important to repeat a survey, done in 1997, on the use thromboembolism prophylaxis among British Orthopaedic Surgeons.
A single page questionnaire was sent out to all 1308 consultants Orthopaedic surgeons who were members of the British Orthopaedic Association. Those who did not respond were sent a reminder letter.
We achieved a 72% response rate. All surgeons use some form of prophylaxis. Eighty five percent of surgeons use pharmacological prophylaxis. Low molecular weight heparin is used by 55% of surgeons. Twenty percent of surgeons use aspirin as their only form of pharmacological prophylaxis. Less than 1% (5 consultants) use early mobilisation alone and nearly 2% (13 consultants) use graded stockings and early mobilisation as their only form of prophylaxis. Seventy four percent of surgeons have a unit policy. Thirty percent have changed their regime in the last 3 years.
The majority of British Orthopaedic surgeons still use pharmacological thromboprophylaxis. There has been a significant increase in the use of Aspirin from 5% to 30%. Aspirin is often combined with a mechanical prophylaxis. This has led to an increase in the use of intermittent calf compression (3% to 22%), and foot pumps (12% to 19%). Low molecular weight heparin use has fallen by 10%.
The majority of British Orthopaedic surgeons still use pharmacological thromboprophylaxis. There has been a significant increase in the use of Aspirin from 5% to 30%. Aspirin is often combined with a mechanical prophylaxis. This has led to an increase in the use of intermittent calf compression (3% to 22%), and foot pumps (12% to 19%). Low molecular weight heparin use has fallen by 10%.
Theses abstracts were prepared by Mr Peter Kay. Correspondence should be address to him at The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.
