![]() Inferior vena cava (IVC) filters are among the mechanical prophylaxis of VTE devices which are used in those with extensive DVT and high risk of PE and have also contraindication of anticoagulation therapy. These devices are expensive and not available in all the centers. In high risk patients pneumatic compression devices are the most effective route of DVT prophylaxis. External pneumatic devices are other mechanical prophylaxis of DVT which could be used in combination with other methods. The types of mechanical prophylaxis include Stockings which are more effective in preventing DVT in the calf than in legs of lower extremities such as elevating the foot, active and passive ankle motion that increasing blood flow through the femoral vein. Mechanical methods are usually used in combination with other methods. The risk of VTE can be reduced at the time of surgery with administration of appropriate prophylaxis regimen. ![]() How is mechanical and pharmacologic prophylaxis used in prevention? Because it will make the active and potential bleeding of these victims, such as intracranial hemorrhage, spinal fractures, pelvic fractures associated with hematoma, bleeding internal organs caused by trauma, and prescription of drugs that can aggravate bleeding. The conditions of traumatic injuries management are more different and harder than prescription of prophylaxis DVT and other medical groups. Therefore, it will increase the likelihood of progression to death, which preventable and it shows the need for prophylaxis. The cost of economic burden of PE and DVT is high, due not only to the initial hospitalization. An autopsy study found 20% death of PE and 65% of fatally injured patients by DVT. Large randomized prospective clinical studies would be required to provide level I evidence to define the optimal VTE prophylaxis in trauma patients. ![]() Both the Eastern Association for the Surgery of Trauma (EAST) and American College of Clinical Pharmacy (ACCP) guidelines recommend primary use of LMWHs in trauma patients however there are still controversies regarding the definitive VTE prophylaxis in trauma patients. Administration of prophylactic dosages of low-dose heparin (LDH), low molecular weight heparin (LMWH), and factor Xa inhibitors is considered the pharmacologic anticoagulation. Mechanical prophylaxis includes graduated compression stockings (GCSs), pneumatic compression devices (PCDs), and A-V foot pumps. Modalities available for trauma patient thromboprophylaxis are classified into pharmacologic anticoagulation, mechanical prophylaxis, and inferior vena cava (IVC) filters. The prophylaxis options for VTE consist of mechanical prophylaxis, pharmacological anticoagulation and placing inferior vena cava (IVC). However the definition of high-risk group for VTE prophylaxis is yet to be defined. According to current lines of evidence it is believed that long bone fractures, pelvic fractures, traumatic brain injury and prolonged hospitalization are risk factors of VTE in patients with trauma. Currently, the optimal VTE prophylaxis strategy for trauma patients is unknown. Previous reports have shown that the incidence of VTE is up to 15% in trauma patients in prophylaxis. The prophylaxis of DVT is trauma practice in order to prevent the subsequent VTE. The incidence of DVT in patients with traumatic injuries is as high as 5-63%. VTE is associated with high mortality and morbidity and increased hospitalization duration and costs. Trauma patients are at high risk for deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) which are collectively referred to venous thromboembolism (VTE). ![]() Trauma is one of the main causes of hospitalization, mortality and morbidity in Iran and the world. ![]()
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