There were two articles regarding deep venous thrombosis prevention in the November 2011 issue of the Plastic and Reconstructive Surgery Journal. Both are worth reading. I have supplied the full references below with links.
I added the references mentioned in the last paragraph to the section below. DVT prevention is important. It can be done safely. It needs to be done.Between 1 and 7 percent of surgeons have personally experienced a venous thromboembolism–related patient death after high-risk plastic surgery. Plastic surgeons' self-reported practice patterns indicate a disparity between clinical understanding and clinical practice. The majority of surgeons can identify patients at high risk for postoperative venous thromboembolism. However, examination of their self-reported practice patterns indicates that a substantial proportion of surgeons (>50 percent) provide inadequate levels of venous thromboembolism prophylaxis for high-risk patients. In addition, surgeons recognize modifiable venous thromboembolism risk factors (such as oral contraceptive use) but may fail to modify those factors before surgery.“Never event” is a poor descriptor for venous thromboembolism, as it implies that all events are potentially preventable. Breakthrough venous thromboembolism events routinely occur in the face of rigorous protocols and criterion-standard prophylaxis, as has been reported in the plastic surgery, orthopedic surgery, and general surgery literature. We observed multiple breakthrough events in the Venous Thromboembolism Prevention Study enoxaparin group, although the distinct causes of these events remain unclear. Unrecognized hypercoagulability has been identified as a major contributor to venous thromboembolism risk. Venous Thromboembolism Prevention Study data support the belief that a prior personal history of venous thromboembolism is an important risk factor as well (Table 3).Venous thromboembolism represents a financial burden for patients and payers. The mean cost of hospitalization for an index deep venous thrombosis event is over $20,000. Previous work has shown that enoxaparin is a cost-effective method of venous thromboembolism prevention. In July of 2010, the U.S. Food and Drug Administration approved production of enoxaparin in generic form, which should result in substantially decreased costs to patients.For a complete overview of venous thromboembolism in plastic surgery, we refer readers to two excellent reviews that have recently been published by Miszkiewicz and colleagues and Venturi and colleagues. These reviews built on the foundation of several outstanding reviews and consensus statements published previously.
Deep Venous Thrombosis Prevention (June 19, 2007)
DVT Prevention (June 4, 2008)
Prevent Pulmonary Thromboembolism – an Article Review (February 23, 2009)
DVT Screening and Prevention (February 3, 2010)