Thromboprophylaxis after Primary Total Knee Replacement

The rate of venous thromboembolism is unacceptable without prophylaxis. Venographic studies of patients without prophylaxis show that the deep vein-thrombosis rates range from 40-84% after total knee replacement, and rates of pulmonary embolism range from 1.5-10%. Surgeons must balance the need for thromboprophylaxis with the need to avoid bleeding complications. The purpose of this study is to evaluate the status of thrombo prophylaxis after primary total knee replacement in ALMouassat university hospital, and to improve our outcome in future, to get better results and fewer complications.

Surgical Treatment of Superficial Veins Thrombosis ( SVT ) in patients with Varicose Vein of the lower extremities

Sample of 60 evaluable patients were included in a prospective study with Superficial Veins Thrombosis(SVT)on ground of varicose vein lower extremities. the study achieved at AL-Assad hospital (Latakia) in the period between January 2005 to December 2011. Criteria of inclusion were incompetence (by Duplex investigation ), a tender indurated cord a long superficial vein, and indurated and heat in the affected area. Exclusion criteria were obesity, cardiovascular or neoplastic diseases, non-ambulatory status, SVT without varicose vein. 60 patients ( 41 females, 19 males) included in the study, 61.6% were between(31–50) years, left lower limb was affected in 48,3 %, Right 40%, and in 11,7 the both, The GSV was affected alone in all cases. Primary surgical choice was decided almost in all patients, secondary was in 4patients after 1-4 weeks of medical treatment. The extension level in the GSV determined by color duplex ultrasound was similar to surgical findings, and above clinical extension level in (5-14) cm. All surgical intervention was achieved under spinal anesthesia, with no major technical difficulties. Short term results were good, no(DVT, PE, acute cardiac ischemia, death ), complications related to surgery(hematoma, seroma5%, wound infection3.3%, wound necrosis1.7%, lymphatic discharge3.3%) show no difference to un complicated varicose surgery. Conclusion: Primary surgical approach can be used with thrombosis of GSV above knee in varicose patients safely and effectively , color duplex ultrasound scans is recommended to determine extension of SVT.