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Physikalische Thromboembolieprophylaxe

Aktueller Wissensstand zur Anwendung medizinischer Thromboseprophylaxestrümpfe

Physical prophylaxis for thromboembolism

Current state of knowledge on use of medical thromboprophylaxis stockings

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Zusammenfassung

Hintergrund

Die medizinische Thromboseprophylaxe besteht aus physikalischen und medikamentösen Maßnahmen. Für die physikalische Behandlung ist in Deutschland die Anwendung von medizinischen Thromboseprophylaxestrümpfen (MTPS) etabliert. Kürzlich erschienene Publikationen stellten den Nutzen einer physikalischen Prophylaxe generell infrage.

Material und Methoden

Eine intensive Literaturrecherche zu dieser Fragestellung wurde durchgeführt. Hierbei wurden Studien in PubMed und Medline identifiziert, die sich mit der Fragestellung des Nutzens einer physikalischen Prophylaxe bei chirurgischen Patienten befasste.

Ergebnisse

Die geringe vorliegende Evidenz für die Thromboseprophylaxe im chirurgischen Patientengut wurde hauptsächlich durch Studien generiert, in denen eine Kombination aus MTPS und einem niedermolekularen Heparin (NMH) zur Anwendung kam. Ergebnisse experimenteller Arbeiten wiesen darüber hinaus die Wirksamkeit der MTPS durch Verringerung des venösen Querschnitts der unteren Extremität nach.

Schlussfolgerung

Zum gegenwärtigen Zeitpunkt besteht keine belastbare Evidenz für einen Verzicht auf MTPS bei chirurgischen Patienten. Dies gilt auch bei Verabreichung der neu eingeführten oralen Anti-Xa- und Anti-IIa-Inhibitoren.

Abstract

Background

Thromboprophylaxis in surgery patients is a combination of physical and medical thromboprophylaxis. The established mode of physical thromboprophylaxis in Germany is graduated compression stockings. Recent publications from various authors generally scrutinized the additional benefits of physical prophylaxis in patients who received medical thromboprophylaxis.

Material and methods

A thorough search was carried out in PubMed and Medline. The focus of the search was on studies which investigated the advantages of physical thromboprophylaxis in surgery patients.

Results

The low amount of evidence available for prophylaxis of thromboembolism in surgery patients was mainly deduced from trials that had a combination of medical and physical thromboprophylaxis as part of the study protocol. The results of experimental investigations were able to show a statistically highly significant reduction of the diameter of lower extremity veins.

Conclusion

There is no current evidence to support refraining from routine use of graduated compression stockings in surgery patients. This is also the case for the new oral anti-Xa and anti-IIa inhibitors.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. P. Kujath und M. Hoffmann geben an, dass kein Interessenkonflikt besteht. Das vorliegende Manuskript enthält keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    P. Kujath & M. Hoffmann

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  1. P. Kujath
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  2. M. Hoffmann
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Correspondence to P. Kujath.

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Kujath, P., Hoffmann, M. Physikalische Thromboembolieprophylaxe. Chirurg 84, 1057–1061 (2013). https://doi.org/10.1007/s00104-013-2626-5

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  • DOI: https://doi.org/10.1007/s00104-013-2626-5

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