Prevention

Walking regularly, not to remain still, is the best way to prevent either thrombosis or pulmonary embolism

In every other person with VTE, a thrombosis appears after surgery or after an immobilization process. In these cases the best measure to prevent a thrombosis is to walk as soon as possible.

Thus, after an operation, the surgeon encourages the patient to get up as soon as possible (the next day if possible), and for patients with an infection, bronchitis or heart failure, we recommend them to sit in a chair and not to stay in bed longer than strictly necessary.

As this is often not enough, and we prescribe anticoagulants (albeit lower doses than the one we usually recommend for VTE).

Drugs with an anticoagulant effect are fundamentally aimed at neutralizing the tendency of excess blood clots in surgical or immobilized patients

Since the mid-70s, both heparin and low weight molecular heparin have been used to prevent the appearance of VTE in surgical and in immobilized patients. In these cases, heparin is usually administered a few hours before or after the operation, depending on the case, followed by a daily injection, as long as the risk persists.

After certain operations the risk of suffering a VTE lasts for several weeks. Therefore, we currently recommend extending the use of low weight molecular heparin for five weeks after a hip or knee prosthesis surgery, or a hip fracture or even in interventions of malignant tumors in the digestive or genitourinary systems.

Since low weight molecular heparin subcutaneous injections and their derivatives- especially if administered during a month – are very annoying for patients, new anticoagulants have been used. These are taken orally and are already available in pharmacies.
Currently, many public health systems do not cover the cost of these drugs.

If anticoagulants are not administered

There are people who cannot use drugs that interfere with coagulation because they have a disease or circumstances in which the risk of hemorrhage is high. For these cases,  elastic stockings or devices that are applied onto the legs, which through intermittent air blowing, compress the calf area and accelerate the venous blood flow, can be used.

For patients at a high risk of suffering a post-operative VTE, we can combine  anticoagulants with physical methods, so as to enhance their effects.

In any case, regardless of the use of these forms of prophylaxis, it is always desirable to make those patients move, and to make them get out of bed ASAP. This is even more important when the patient has already had a VTE previously.

In any case, regardless of the use of these forms of prophylaxis, it is always desirable to mobilize those patients and to make them get up from their beds as soon as possible.

But a person who has already had an episode of VTE should avoid being in bed or sitting too long, he/she must walk as much as possible and avoid drugs that may induce a thrombosis (such as estrogen, for example).

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