Why the study?
Do low-molecular-weight heparins have advantages over conventional unfractionated heparins in patients undergoing major orthopaedic surgery?
Do low-molecular-weight heparins have advantages over conventional unfractionated heparins in patients undergoing major orthopaedic surgery?
This article reviews whether low-molecular-weight heparins offer advantages over conventional unfractionated heparins for deep vein thrombosis prophylaxis in major orthopaedic surgery.
LMWHs should not supplant UFH for DVT prophylaxis in major orthopaedic surgery; leaves superiority question open for definitive trials.
Deep vein thrombosis (DVT) occurs in over two-thirds of patients undergoing major orthopaedic surgery (for hip fracture or hip or knee replacement) unless they are given prophylaxis.1 Low-dose heparin is the prophylactic drug most commonly used by orthopaedic surgeons in the UK;2 it reduces the incidence of DVT by half and lowers the risk of fatal pulmonary embolism by two-thirds.3 Low-molecular-weight (LMW) heparins, which affect only one component (factor Xa) of the clotting cascade, were developed in an attempt to reduce the risk of major bleeding that accompanies treatment with conventional (unfractionated) heparins.3–5 Do LMW heparins have advantages over the cheaper conventional forms?
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A 1993 study studied this question.
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