Subject(s)
COVID-19/diagnostic imaging , Mass Screening/methods , Pneumonia, Viral/diagnostic imaging , Surgical Procedures, Operative , Tomography, X-Ray Computed , COVID-19/epidemiology , Female , Humans , Male , Northern Ireland/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2ABSTRACT
Two hundred and thirty-eight patients with femoral neck fractures were entered into a randomised pilot study comparing the use of sequential treatment by 'Flowtron DVT' garments in the perioperative period followed by Enoxaparin (Clexane-Rhône-Poulenc Rorer), and Enoxaparin alone. One hundred and ninety-three patients were excluded indicating the difficulty of achieving pure comparisons in this population. The remaining 44 were randomised: 21 received Enoxaparin from the time of admission, and 23 had sequential treatment. There was no statistically significant difference in the incidence of thromboembolism. Patient preference did not indicate a favoured treatment subjectively. The operation field was drier in the sequential group, although this did not reach significance. Sequential treatment was not shown to be better or worse than treatment with Enoxaparin, but the trends favoured sequential treatment rather than drug treatment alone. The technique allows the operation to be carried out without the problems produced by low dose heparins and mobilisation is not hindered by compression garments.
Subject(s)
Anticoagulants/therapeutic use , Enoxaparin/therapeutic use , Femoral Neck Fractures/surgery , Gravity Suits , Postoperative Complications/prevention & control , Thrombophlebitis/prevention & control , Adult , Aged , Aged, 80 and over , Combined Modality Therapy , Female , Humans , Male , Middle Aged , Pilot Projects , Postoperative Care , Postoperative Complications/epidemiology , Pulmonary Embolism/epidemiology , Pulmonary Embolism/prevention & control , Thrombophlebitis/epidemiology , Treatment OutcomeABSTRACT
A prospective randomised trial was carried comparing the use of Enoxaparin with intermittent pneumatic calf compression garments for thromboprophylaxis in total hip replacement. Fifty consecutive patients were studied and randomised to evaluate these two methods. There were 2 deep vein thromboses, one in each group, and no cases of pulmonary embolism. The operative field was judged to be drier in the compression group, but the mean fall in the postoperative haemoglobin level was the same in each. In the peroperative period, 6 patients in the Enoxaparin group needed 2 units of blood and one 3 units. In the compression group, 3 patients needed transfusions of 2 units. Intermittent calf compression has fewer problems than the use of Enoxaparin and has no contraindications.
