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The Journal of Bone and Joint Surgery, Vol 67, Issue 1 57-62, Copyright © 1985 by Journal of Bone and Joint Surgery, Inc
Prophylaxis of deep-vein thrombosis after total hip replacement. Dextran and external pneumatic compression compared with 1.2 or 0.3 gram of aspirin daily
WH Harris, CA Athanasoulis, AC Waltman and EW Salzman
The efficacy of three prophylactic regimens against deep venous thrombosis
was assessed in 135 patients who were more than thirty-nine years old and
had a total hip replacement. The three regimens were 1.2 grams of aspirin
daily, 0.3 gram of aspirin daily, and external pneumatic compression of the
calf and thigh combined with low-molecular-weight dextran that was given
for three days, beginning during the operation. In all patients, detection
of fresh thrombi was by the fibrinogen-uptake test, cuff-impedance
plethysmography, and venography. New venous thromboses developed in
twenty-nine of forty-eight patients receiving 1.2 grams of aspirin and in
twenty-six of forty-three receiving 0.3 gram of aspirin, indicating that
the lower dose of aspirin had no advantage. Thromboembolic disease
developed in only nine of forty-four patients who were on the regimen of
external compression and dextran. This combination was significantly better
than aspirin in both men and women. Dextran appeared to be associated with
excessive bleeding when given in doses of more than 500 milliliters during
the operation, but not when given in less than that amount.
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