Intermittent pneumatic compression device is a standard component for prevention of deep venous thrombosis in immobile patients. This method has been known to be safe with very low rate of complications compared to medical thromboprophylaxis. Therefore, this modality has been used widely in patients who underwent a general surgery. We report a patient who developed common peroneal nerve palsy during the use of intermittent pneumatic compression device after Hartmann's operation.
Humans ; Intermittent Pneumatic Compression Devices ; Paralysis ; Peroneal Nerve ; Peroneal Neuropathies ; Postoperative Complications ; Venous Thrombosis

PURPOSE: The purpose of this pilot study was to investigate the effects of mechanical interventions for deep vein thrombosis (DVT) prophylaxis in surgical intensive care unit (SICU) patients. METHODS: The participants were assigned to the intermittent pneumatic compression (IPC) and graduated compression stocking (GCS) intervention. Patients who met the criteria were selected for comparison from our previous study. Data for 140 patients were included in the final analysis. RESULTS: The mean age was 57.5 (+/-15.7) and 61.4% were men. About forty-seven percent of the participants were 61 years or over. In the second duplex scan, 3, 2 and 1 critically ill patients developed deep vein thrombosis in the control, GCS, and IPC groups, respectively. Incidences of DVT were 6.0%, 5.0%, and 2.0% for the control, GCS, and IPC groups, respectively. This difference was not significant. Relative risks of no intervention were 3.0 and 1.2 compared with IPC and GCS application. There were no significantly different variables among the three groups before the intervention except for diagnosis on admission. CONCLUSION: Although it may difficult to conclude that mechanical prophylaxis effectively prevents DVT among SICU patients because there was no statistical significance in this study, but incidence rates among the three groups differed greatly. The findings reveal that further study should be conducted with larger samples and randomized controlled trial for SICU patients.
Critical Care ; Critical Illness ; Diagnosis ; Humans ; Incidence ; Critical Care ; Intermittent Pneumatic Compression Devices ; Male ; Pilot Projects* ; Stockings, Compression* ; Venous Thrombosis*

BACKGROUNDVenous thromboembolism is known to be an important social and health care problem because of its high incidence among patients who undergo surgery. Studies on the mechanical prophylaxis of thromboembolism after gynaecological pelvic surgery are few. The aim of our study was to evaluate the effect of mechanical thromboembolism prophylaxis after gynaecological pelvic surgery using a combination of graduated compression stockings (GCS) and intermittent pneumatic compression (IPC) or GCS alone.

METHODSThe study was performed on 108 patients who were randomly assigned to two groups. The first group received GCS before the operation and IPC during the operation (IPC + GCS group). The second group received GCS before the operation (GCS group). To analyze the effect of the preventive measures and the laboratory examination on the incidence of thrombosis and to compare the safety of these measures, the incidence of adverse reactions was assessed.

RESULTSThe morbidity associated with DVT was 4.8% (5/104) in the IPC + GCS group and 12.5% (14/112) in the GCS group. There were significant statistical differences between the two groups. There were no adverse effects in either group.

CONCLUSIONSThe therapeutic combination of GCS and IPC was more effective than GCS alone for thrombosis prevention in high-risk patients undergoing gynaecological pelvic surgery, and there were no adverse effects in either group.

Aged ; Female ; Gynecologic Surgical Procedures ; adverse effects ; Humans ; Intermittent Pneumatic Compression Devices ; Male ; Middle Aged ; Pelvis ; surgery ; Stockings, Compression ; Thromboembolism ; etiology ; prevention & control ; Venous Thrombosis ; etiology ; prevention & control

Intermittent pneumatic compression (IPC) device is an effective method to prevent deep vein thrombosis. This method has been known to be safe with very low rate of complications compared to medical thromboprophylaxis. Therefore, this modality has been used widely in patients who underwent a hip fracture surgery. We report a patient who developed extensive bullae, a potentially serious skin complication, beneath the leg sleeves during the use of IPC device after hip fracture surgery.
Aged, 80 and over ; Blister/*etiology/pathology ; Female ; Hip Fractures/*surgery ; Humans ; Intermittent Pneumatic Compression Devices/*adverse effects ; *Postoperative Complications ; Venous Thromboembolism/prevention & control

PURPOSE: This study was conducted to adapt the standardized evidence-based nursing protocol using the IPC (intermittent pneumatic compression) intervention to prevent venous thromboembolism in surgical patients. Further, an investigation was done to measure knowledge on prevention of venous thromboembolism, surrogate incidence of venous thromboembolism and to assess IPC compliance in the study patients compared with those in surgical patients who underwent IPC intervention due to previous clinical experience. METHODS: An analysis was done of the nine modules suggested by National Evidence-based Healthcare Collaborating Agency (NECA) in the adaptation manual of the clinical practice guideline for protocol adaptation. A nonequivalent control group post test design as a quasi-experiment was used to verify the effect of the IPC protocol. RESULTS: There was a significant difference in knowledge of prevention of venous thromboembolism, IPC application time after intervention and the number of IPC applications between the experimental group (n=50) using the IPC nursing protocol and the control group (n=49). However, the symptoms of deep vein thrombosis and pulmonary thromboembolism were not observed in either the experimental group or the control group after the intervention. CONCLUSION: Results confirm that the standardized IPC nursing protocol provides effective intervention to prevent venous thromboembolism in surgical patients.
Compliance ; Evidence-Based Nursing ; Evidence-Based Practice ; Humans ; Incidence ; Intermittent Pneumatic Compression Devices ; Nursing Assessment* ; Nursing* ; Pulmonary Embolism ; Venous Thromboembolism* ; Venous Thrombosis

Venous thromboembolism (VTE) is a potentially fatal complication that is relatively common after hip surgery. Since patients with a hip fracture have a higher risk of preoperative VTE due to an inability to ambulate after injury and aggravation of underlying age-related conditions, it may be difficult to effectively prevent VTE using only conventional approaches. Very few studies have been published reporting on the prevalence and prevention of VTE in patients with a hip fracture compared to those with hip arthroplasty. For this reason, we aimed to share recent updates on the diagnosis and prevention of VTE in patients with a hip fracture. Preoperative screening tests to diagnose VTE need to be performed more actively following hip fracture and indirect multidetector computed tomography venography is considered the most effective test for this purpose. As the risk of VTE appears to increase with time following a hip fracture, preventive measures should be taken as soon as possible in patients with a hip fracture. A wide variety of mechanical and pharmacological options are available for prophylaxis. When considering patient compliance and preventive impact, intermittent pneumatic compression devices and foot pumps are recommended as mechanical modalities. Of the available preventive medications for patients with a hip fracture, low molecular weight heparin seems to be the most appropriate option because of its short half-life and fast onset of action. Surgery should be performed as soon as possible in patients with hip fractures, and we recommend mechanical and pharmacological methods as active interventions immediately after injury to prevent VTE.
Arthroplasty ; Diagnosis* ; Foot ; Half-Life ; Heparin, Low-Molecular-Weight ; Hip Fractures ; Hip* ; Humans ; Intermittent Pneumatic Compression Devices ; Mass Screening ; Multidetector Computed Tomography ; Patient Compliance ; Phlebography ; Prevalence ; Venous Thromboembolism*

Laparoscopic sleeve gastrectomy is a surgical procedure for patients who want to lose weight. An acute porto-mesenteric vein thrombosis is an infrequent but not rare complication in patients who undergo laparoscopic sleeve gastrectomy. In this article, we present a 40-year-old male patient with body mass index of 47 kg/m² was admitted for laparoscopic sleeve gastrectomy. The surgery took about 130 minutes without any hemorrhage. Full enoxaparin prophylaxis, early and full mobilization, and intermittent pneumatic compression stockings were all applied to prevent venous thrombosis. Unfortunately, he applied to our emergency department and diagnosed to have porto-mesenteric vein thrombosis. There was an approximately 60 cm necrotic jejunal segment between 10th and 70th cm after Treitz ligament and was resected. He was discharged on sixth post operative day with prescription of oral warfarin.
Adult ; Bariatric Surgery ; Body Mass Index ; Emergency Service, Hospital ; Enoxaparin ; Gastrectomy ; Hemorrhage ; Humans ; Intermittent Pneumatic Compression Devices ; Ligaments ; Male ; Obesity ; Prescriptions ; Thrombosis ; Veins ; Venous Thrombosis ; Warfarin

PURPOSE: This study was done to evaluate the mean venous velocity (MVV) response with knee and thigh length compression stockings (CS) versus intermittent pneumatic compression (IPC) devices in immobile patients with brain injuries. METHODS: We carried out a randomized controlled study. We analyzed both legs of a randomly chosen sample of 43 patients assigned to one of 4 groups (86 legs). The patients were sequentially hospitalized in the intensive care unit (ICU) in "S hospital" from November 2005 to December 2006. The base line and augmented venous velocity was measured at the level of the common femoral vein. We applied leg compression 42 times over 7 days (for 2 hours at a time at 2 hour intervals). RESULTS: There was a statistical difference among the 4 groups. The difference for the "IPC" group was more significant than the "CS" group. CONCLUSION: These results indicate that the application of IPC can be considered as an effective method to prevent deep vein thrombosis for immobile patients with brain injury.
Adult ; Blood Flow Velocity ; Brain Injuries/*physiopathology ; Female ; Femoral Vein/*physiopathology ; Humans ; Intensive Care Units ; Intermittent Pneumatic Compression Devices ; Lower Extremity ; Male ; Middle Aged ; Stockings, Compression ; Venous Thrombosis/*prevention & control

Pregnancy-related venous thromboembolism (VTE) is one of the leading causes of maternal morbidity and mortality, developed in the antenatal and postpartum periods of pregnancy. The incidence of VTE during normal pregnancy is four- to six-fold higher than in the general reproductive aged female population. Physiologic changes such as hypercoagulable state, decreased venous capacitance, and reduced venous blood flow due to mechanical obstruction from gravid uterus compromise this condition. The prominent risk factors for VTE are thrombophilia, history of circulatory disease and previous VTE, preeclampsia and related disorders, and Cesarean section. In case of suspicion of VTE, prompt diagnosis and management are needed with the caution of potential adverse effects on the fetus. Low molecular weight heparin treatment is preferred due to better safety, more consistent bioavailability, ease of administration, lower risk of drug-related osteoporosis and thrombocytopenia and easier monitoring. For pregnant women with acute VTE, adjusted-dose subcutaneous low molecular weight heparin should be administrated antenatally and continued for at least 6 weeks postpartum. For prevention of VTE, mechanical prophylaxis such as physiotherapy, exercise, compression stockings, and intermittent pneumatic compression devices could be used. Thromboprophylaxis should also be considered for pregnant subjects with certain risks such as carriers of molecular thrombophilia or previously experienced VTE.
Biological Availability ; Cesarean Section ; Diagnosis ; Female ; Fetus ; Heparin, Low-Molecular-Weight ; Humans ; Incidence ; Intermittent Pneumatic Compression Devices ; Mortality ; Osteoporosis ; Postpartum Period ; Pre-Eclampsia ; Pregnancy* ; Pregnant Women ; Risk Factors ; Stockings, Compression ; Thrombocytopenia ; Thromboembolism* ; Thrombophilia ; Uterus ; Venous Thromboembolism

OBJECTIVETo investigate the effects of intermittent pneumatic compression (IPC) on coagulation function, deep venous hemodynamics and prevention of deep venous thrombosis (DVT) of lower limbs in patients after rectal cancer resection.

METHODSA total of 120 patients undergoing rectal cancer resection were randomly divided into non-IPC group (control group, n=60) and IPC group (n=60). The control group received routine treatment after resection and the IPC group received IPC based on the routine treatments. Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), international normalized ratio (INR) and volume of D-dimer (D-D) were detected before operation and 1-, 3-, 5- and 7-day after operation. Meanwhile, blood flow velocity and caliber of external iliac vein, femoral vein and popliteal vein were examined by color Doppler ultrasound, then the average blood flow velocity and blood flow volume were calculated.

RESULTSIncidence of lower limb DVT was 13.3% (8/60) and 1.7% (1/60) in control group and IPC group respectively with significant difference (P<0.05). The differences in PT, APTT and INR were not significant (P>0.05) at 1-day after operation as compared to the preoperative level, while FIB and D-D both increased (P<0.05), all presented no significant difference among the two groups (P>0.05). PT shortened gradually (P<0.05), APTT and INR did not change significantly (P>0.05), FIB and D-D increased gradually (P<0.05), and no significant differences were found between the two groups at the same time point (all P>0.05). All the above parameters in the control group were significantly lower than those in IPC group (all P<0.05).

CONCLUSIONSIPC can improve hemodynamics indexes of deep veins of lower limb in patients after rectal cancer operation, and prevent the lower limb DVT. IPC is a safe, simple and convenient physical therapy.

Aged ; Female ; Femoral Vein ; physiology ; Hemodynamics ; physiology ; Humans ; Intermittent Pneumatic Compression Devices ; Lower Extremity ; blood supply ; Male ; Middle Aged ; Postoperative Care ; Postoperative Complications ; prevention & control ; Rectal Neoplasms ; surgery ; Venous Thrombosis ; etiology ; prevention & control