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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 1, 107-110.
doi: 10.1302/0301-620X.88B1.17003  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Assessment of a self-administration protocol for extended subcutaneous thromboprophylaxis in lower limb arthroplasty

A. C. Watts, MRCS(Ed), SpR Orthopaedics1; C. R. Howie, FRCS(Orth), Consultant Orthopaedic Surgeon1; and A. H. R. W. Simpson, FRCS(Orth), Professor of Orthopaedic Surgery1

1 Elective Orthopaedic Unit New Royal Infirmary, Little France, Old Dalkeith Road, Edinburgh EH16 4SU, UK.

Correspondence should be sent to Mr C. R. Howie; e-mail: Colin.Howie{at}luht.scot.nhs.uk

The risk of venous thromboembolism in patients following arthroplasty may be reduced by continuing chemical thromboprophylaxis for up to 35 days post-operatively. This prospective cohort study investigated the compliance of 40 consecutive consenting patients undergoing lower limb arthroplasty with self-administration of a recommended subcutaneous chemotherapeutic agent for six weeks after surgery. Compliance was assessed by examination of the patient for signs of injection, number of syringes used, and a self-report diary at the end of the six-week period. A total of 40 patients, 15 men and 25 women, were recruited. One woman was excluded because immediate post-operative complications prevented her participation. Self-administration was considered feasible in 87% of patients (95% confidence interval (CI) 76 to 98) at the time of discharge. Among this group of 34 patients, 29 (85%) were compliant (95% CI 73 to 97). Patients can learn to self-administer subcutaneous injections of thromboprophylaxis, and compliance with extended prophylaxis to six weeks is good.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General