• Revista clínica española · Jun 2020

    Review

    Thromboembolism prophylaxis in orthopaedic surgery and trauma.

    • J Gutiérrez Guisado.
    • Universidad Francisco de Vitoria, Departamento de Medicina Interna, Hospital Asepeyo Coslada, Madrid, España. Electronic address: javigu65@yahoo.es.
    • Rev Clin Esp. 2020 Jun 10.

    AbstractThromboembolism prophylaxis is well-established in major orthopaedic surgery (hip and knee arthroplasty and hip fracture surgery), with low-molecular-weight heparins the most often chosen agent. In recent years, however, direct-acting anticoagulants have been gaining ground and can be used in this scenario (except for hip fracture surgery). In the US, even aspirin could be indicated for low-risk patients who undergo hip or knee arthroplasty. For other orthopaedic procedures (leg surgery below the knee, ankle and foot; knee arthroscopy; arm surgery; and spine surgery), thromboembolism prophylaxis requires individualisation based on the patient's risk factors and the surgery's characteristics, given that the risk of venous thromboembolic disease is minor. In this patient group, the agent of choice is low-molecular-weight heparin, given that direct-acting anticoagulants are not approved for these types of surgery.Copyright © 2020. Publicado por Elsevier España, S.L.U.

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