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Clin Colon Rectal Surg 2013; 26(03): 153-159
DOI: 10.1055/s-0033-1351130
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Venous Thromboembolism Prophylaxis

Jonathan Laryea
1   Division of Colon and Rectal Surgery, Department of surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
,
Bradley Champagne
2   Division of Colon and Rectal Surgery, Department of surgery, Case Western Reserve University, Cleveland, Ohio
› Author Affiliations
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Publication History

Publication Date:
19 August 2013 (online)

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Abstract

Venous thromboembolism (VTE) can occur after major general surgery. Pulmonary embolism is recognized as the most common identifiable cause of death in hospitalized patients in the United States. The risk of deep venous thrombosis (DVT) and pulmonary embolism (PE) is higher in colorectal surgical procedures compared with general surgical procedures. The incidence of venous thromboembolism in this population is estimated to be 0.2 to 0.3%. Prevention of VTE is considered a patient-safety measure in most mandated quality initiatives. The measures for prevention of VTE include mechanical methods (graduated compression stockings and intermittent pneumatic compression devices) and pharmacologic agents. A combination of mechanical and pharmacologic methods produces the best results. Patients undergoing surgery should be stratified according to their risk of VTE based on patient risk factors, disease-related risk factors, and procedure-related risk factors. The type of prophylaxis should be commensurate with the risk of VTE based on the composite risk profile.

Keywords

venous thromboembolism - deep venous thrombosis - pulmonary embolism - prevention - mechanical agents - pharmacologic agents - risk stratification
 

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