Thromboprophylaxis in Orthopedic surgery - an update

Abstract for the symposium in Oradea from 16^th to 17^th of October 2008

Thromboprophylaxis in Orthopedic surgery - an update

M.E. Wenzl

Deep vein thrombosis (DVT) and pulmo 23323y2414x nary embolism are severe sometimes life threatening complications. Beside these early adverse events DVT can damage the venous vascular system permanently and so lead to postthrombotic syndromes.

The individual risk to get DVT or PE depends on intrinsic factors as hereditary defects of the coagulation system, overweight, age and so on and on extrinsic factors as trauma or operation.

Today it is well known that all patients with major orthopaedic surgery or major trauma are at high risk for thromboembolism. According to the newest 8^th ACCP-Guidelines all patients who are at high risk should receive as well physical as pharmacological prophylaxis.

For many years unfractionated heparin (UFH) and increasingly low molecular weight heparin (LMWH) were the drugs of choice. Both have to be administered subcutaneously by injection.

So new orally applicable drugs have been developed as dabigatran and rivaroxaban.

In this talk a overview is given on the well proofed regimens of thromboprophylaxis by heparin and a view in the future to line out the possible importance of the new drugs.