Borow M, Goldson HJ.
Prevention of postoperative deep venous thrombosis and pulmonary emboli with
combined modalities.
Am Surg 1983 Nov;49(11):599-605

Worldwide statistics reveal that 25 to 40 per cent of patients who are over the
age of 40 years and operated on for 1 or more hours will develop a deep venous
thrombosis (DVT). The studies reviewed in this paper were performed to evaluate
several modalities and compare their effectiveness in preventing DVT in
postoperative patients. In the first study, five modalities plus a control group
were evaluated in 562 patients from five surgical specialties. The incidence of
DVT in the control group was 35 per cent. Though most of the pharmacologic agents
were effective in reducing the incidence of DVT, the antistasis devices (gradient
elastic stockings and intermittent pneumatic compression) were most effective.
The purpose of the second study was to evaluate the effectiveness of combining a
pharmacologic drug with an antistasis modality. Deep venous thrombosis was
virtually eliminated in this group of 328 patients. There was only a 1.5 per cent
incidence of DVT in the treated population as compared to a 26.8 per cent
incidence in the control group. Thus, it seems that combining one antistasis and
one pharmacologic agent greatly reduces the incidence of lower extremity thrombi.
I-125 fibrinogen scanning was the most sensitive test in detecting DVT and had an
accuracy of 97 per cent.