Thromboembolic disease and thromboprophylaxis in oral and maxillofacial surgery : experience and practice.
(i) To determine the incidence of thromboembolic disease (TED) in major maxillofacial surgery and in particular deep vein thrombosis (DVT) and pulmonary embolism (PE). (ii) To determine current thromboprophylactic practice in the specialty.
Design-Retrospective survey by questionnaire of five year experience and current practice in UK maxillofacial surgical units.
Subjects-The patients of 130 consultants carrying out major maxillofacial surgery.
Main outcome measures- (i) The number of cases of fatal and non-fatal PE and the number of diagnosed cases of DVT not progressing to PE. (ii) The frequency of use of mechanical and pharmacological thromboprophylactic measures.
(i) There was a 79% return of questionnaires and from these were reported 60 cases of PE of which 14 were fatal with 64 cases of DVT not progressing to PE.
Of the PE group almost 60% followed operations for orocervical malignancy while 25% were related to maxillofacial trauma. 64% of respondents had encountered no episodes of perioperative DVT and 68% no cases of PE. (ii) Mechanical thromboprophylactic measures included the use by 76% of respondents of a graduated compression garment, ripple mattress by 47% and intermittent inter-operative calf pressure by 38.5%. Of pharmacological agents 45% used low dose heparin, 14.5% a dextran infusion and 6% an antiplatelet agent. 58.3% gave advice about smoking and 37.5% recommended temporary discontinuation of the contraceptive pill.
Mots-clés Pascal : Thromboembolie, Chirurgie, Maxillofacial, Veine profonde, Homme, Diagnostic, Incidence, Facteur risque, Epidémiologie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie
Mots-clés Pascal anglais : Thromboembolism, Surgery, Maxillofacial, Deep vein, Human, Diagnosis, Incidence, Risk factor, Epidemiology, Cardiovascular disease, Vascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0246748
Code Inist : 002B12B03. Création : 09/06/1995.