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Die intermittierende Impulskompression zur Abschwellung und Thromboseprophylaxe – Pilotstudie nach Hüft-TEP

Ist die Minimalanwendungsdauer von 2 h täglich ausreichend?

Intermittent compression devices for swelling reduction and thrombosis prophylaxis – a pilot study after total hip replacement

Is the 2 hour daily minimum application sufficient?

  • Medizin aktuell / Technische Innovationen
  • Published:
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Zusammenfassung

Hintergrund

Die Verwendung von maschinellen Impulskompressionssystemen zur Thromboseprophylaxe und Schwellungsverminderung stellen zunehmend akzeptierte Methoden dar. Damit möglichst viele Patienten von diesem System profitieren, ist ein effizienter und zeitökonomischer Einsatz notwendig. Die Mindestanwendungsdauer wird mit 2 h täglich angegeben, was aber derzeit noch nicht wissenschaftlich belegt ist.

Patienten und Methoden

Unter Verwendung des A-V-Impulse-Systems™ wurde prospektiv randomisiert an 41 Patienten nach Implantation einer Hüfttotalendoprothese (Hüft-TEP) überprüft, ob mit der Mindestanwendungsdauer ein ausreichender Effekt erzielt werden kann.

Ergebnisse

Postoperativ kam es in der Kontrollgruppe zu 2 Beinvenenthrombosen, während die Impulskompressionsgruppe thrombosefrei blieb. Keine Unterschiede zeigten sich im Ober- und Unterschenkelumfang, auch nicht in der Schmerzanalogskala nach schmerzbedingtem Abbruch zweier Impulskompressionspatienten.

Schlussfolgerung

Das Ergebnis dieser Pilotstudie legt nahe, dass bereits ein sehr kurzer, aber gezielter Einsatz einer maschinellen Impulskompression die Thromboseneigung reduzieren kann. Zur Erstellung von endgültigen Entscheidungsrichtlinien wäre die Überprüfung durch groß angelegte Studien angezeigt.

Abstract

Background

The use of intermittent compression devices for thrombosis prophylaxis and the reduction of postoperative swelling are widely accepted. The recommended minimum application of 2 h daily has never been statistically verified. Without evidence based data, the benefit of this costly equipment cannot be maximized.

Patients and methods

A randomized clinical trial on 41 patients after total hip replacement was performed. The A-V Impulse System was applied for 2 h a day during the first 5 postoperative days to observe whether this time was sufficiently effective.

Results

In the control group, two deep vein thromboses occurred postoperatively, but there were none in the treatment group. Even though two patients from the treatment group had to be excluded from the study because of severe pain, all other parameters including visual analogue pain scale results and limb circumferences were comparable in both groups.

Conclusion

These preliminary results suggest that pump systems can prevent deep venous thrombosis after hip surgery even when applied for only short intervals over a short period of time. However, large scale confirmatory studies are needed.

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Danksagung

Einen Dank für die Unterstützung möchten die Autoren Schwester Ingrid Moser und ihrem Team aus dem 1. Stock, Haus 1 (Department II) aussprechen.

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Authors and Affiliations

  1. Department für Erkrankungen der Wirbelsäule und Wirbelsäulenchirurgie, Allgemeines und Orthopädisches LKH, 8852, Stolzalpe, Österreich

    G. M. Ivanic, I. Moser, N. C. Homann, M. Pietsch, P. Kriechhammer & A. Hennerbichler

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  1. G. M. Ivanic
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  2. I. Moser
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  3. N. C. Homann
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  4. M. Pietsch
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Correspondence to G. M. Ivanic.

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Ivanic, G.M., Moser, I., Homann, N.C. et al. Die intermittierende Impulskompression zur Abschwellung und Thromboseprophylaxe – Pilotstudie nach Hüft-TEP. Unfallchirurg 109, 786–792 (2006). https://doi.org/10.1007/s00113-006-1140-3

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