Reilly DT.
Prophylactic methods against thromboembolism.
Acta Chir Scand Suppl 1989;550:115-8

Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston,
Massachusetts.

Deep vein thrombosis and pulmonary embolism are significant hazards of surgery,
especially in orthopedic procedures. However, the true incidence of these
complications is unknown. Many surgeons are now using prophylactic methods to
prevent the postoperative occurrence of thromboembolic disease. Pneumatic
compression devices are recommended in some instances, especially in cases where
increased bleeding could be devastating. Several pharmacologic agents are also
used, alone or in combination with pneumatic devices. These include subcutaneous
heparin, warfarin, dextran, and aspirin. Each agent has advantages and
disadvantages. The US National Institutes of Health (NIH) and numerous ongoing
clinical trials are attempting to establish recommendations and guidelines for
the use of prophylaxis against postoperative deep vein thrombosis and pulmonary
embolism.