September 20, 2022
Don’t be a Clot… Statistic – How to Prevent Blood Clots After Surgery
Complications following any Orthopaedic surgery can occur. Blood clots, more commonly known as deep vein thrombosis (DVT) can easily form in the limbs, especially the legs, following any surgery that results in reduced activity for a period of days. Keep reading to find out how to prevent blood clots after surgery and whether you might be at an increased risk.
What can happen if you get a blood clot after surgery?
It is fair to say that we as clinicians have become quite obsessed with trying to prevent postoperative DVT as it can have significant consequences. Not only can the clot travel to the lungs, with possible fatal consequences, but also may cause long-term damage to the veins, reducing circulation and increasing long-term swelling and pain. This situation is known as post-thrombotic syndrome.
How can I prevent a blood clot after surgery?
Now, whilst this information might be a bit scary, understanding the risk factors that can lead to DVT will help you to reduce the risk. We as clinicians consider a number of risk factors as part of the pre-operative workup. We complete specific forms which are attached to the medical notes documenting any of the risks identified. Unfortunately, whilst we can identify risks and provide appropriate prophylactic measures, we do not have a definitive formula for prevention. What we mean by that is that we can only reduce the risk and not eliminate it completely.
How do I know if I’m more at risk?
Factors we consider include:
1. Age – patients over 60 are at higher risk
2. Weight – obesity increases risk, especially BMI greater than 30
3. Personal or family history – patient history or first-degree relative history of clots
4. HRT or contraceptive medication – oestrogen-containing medication increases risk
5. Varicose or pre-existing damaged veins
6. Immobility post-op – patients who are non-weight bearing or immobilised in a cast have an increased risk
7. Duration of surgery – operations taking longer than 90mins have a higher risk
8. Type of surgery – hip and knee replacement carries a high risk
9. Smoking – damages circulation and can increase risk
How can I prevent blood clots after surgery?
Some of these factors such as weight and smoking can be improved by yourself. Keeping yourself fit and choosing a healthy lifestyle will reduce risk significantly should you ever need an operation. Temporarily stopping HRT/contraceptive medication 4 weeks before surgery reduces risk. Keeping well-hydrated post-op, by drinking 2 litres of water daily, will also reduce risk.
If your surgeon considers your risk to be low, then simple exercises to move the affected limb along with good hydration will be advised. In high-risk cases, whilst in hospital, mechanical pumps to squeeze the calf, compression stockings and injections of blood thinners into your tummy may be prescribed. You may go home with injections to self-administer or a blood thinning tablet to take daily for a prescribed period of time. After the first 2 weeks, aspirin may be used for a period of 6-8 weeks to further reduce risk.
If you are particularly worried about blood clots, do speak to your surgeon who will discuss this in more detail.
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