The Prevention of Blood Clots (Venus thromboembolism Prophylaxis [Deep Vein Thrombosis & Pulmonary Embolus]) during Orthopaedic Surgery
In June 2010 NICE (National Institute for Clinical Excellence) published guidelines for all surgeons on VTE Prophylaxis. One section of the guidelines is dedicated to Orthopaedic Surgery. In response to this document the British Orthopaedic Association intends to publish a Blue Book to help its Members identify those patients most at risk from this potentially dangerous condition.
Not all operations have the same potential for blood clots to develop, and the risk is different in every patient.
Therefore during your pre-operative assessment appointment with your Surgeon or one of the team they will be looking closely at various indicators that help them assess your risk of clotting in relation to the operation you are about to have.
Some of the factors they will be looking at include:
Your age & weight,
if you smoke,
if you are pregnant or taking oral contraceptives or hormone replacement therapy,
if you have varicose veins and how easily your blood clots.
How well your heart & lungs are working
If you or your family have a history of bleeding or clotting problems
how well you get around,
if you have cancer
how long you will be in theatre & how long you will have to stay in bed after the operation.
As a patient you should have the expectation that your surgical team will discuss these issues with you &/or your family/carer, and that you will be treated with the most appropriate and up-to-date therapies available in line with the current guidelines.
Your surgeon will then balance the risk of your developing a clot against the extra risk of bleeding during and immediately after the surgery.
Your surgeon will be able to decide if you need thrombo-prophylaxis (treatment to reduce the risk of clots) and which method to adopt. These methods include mechanical appliances (e.g. elastic stockings) and pharmacological (drugs given either by injection or by mouth).
So, following this assessment you will be given the appropriate preventative measures, unless there are medical reasons why this is not be advisable.