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VOLUME 2 , ISSUE 1 ( January-June, 2019 ) > List of Articles

Original Article

Incidence, Etiopathogenesis, and a Preventive Protocol of Deep Vein Thrombosis in Severe Burns Patients at a Tertiary Care Teaching Hospital

R Ravishanker, Danturti Niharika

Keywords : Deep vein thrombosis, High incidence, Protocol for prevention, Severe burns patients, Teaching institution

Citation Information : Ravishanker R, Niharika D. Incidence, Etiopathogenesis, and a Preventive Protocol of Deep Vein Thrombosis in Severe Burns Patients at a Tertiary Care Teaching Hospital. Journal of Medical Academics 2019; 2 (1):6-10.

DOI: 10.5005/jp-journals-10070-0030

License: CC BY-NC 4.0

Published Online: 01-08-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Deep vein thrombosis (DVT) a consequence of thromboembolism can lead to life threatening pulmonary embolism. A study was carried over 4 years from January 2014 to January 2018 to determine the incidence of DVT in severe burns cases admitted to the Burns Unit of a 1200 bed tertiary care medical college teaching hospital. In the retrospective study of 100 consecutive cases of severe burns the incidence of DVT was found to inordinately high. This study was carried out to determine the causes of DVT in these patients and formulate a protocol for the prevention of DVT. A further prospective study of 116 cases were studied following the introduction of the protocol. A dramatic decrease in the incidence was found. This protocol is recommended to be followed in all burns centres especially in teaching institutions.


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  1. Ikejiri M, Shindo A, et al. The association of protein S Tokushima-K196E with a risk of deep vein thrombosis. Int J Hematol 2010;92(2):302–305.
  2. National Heart, Lung and Blood institute. http:/www.nhlbi.nih.gov/health/health-topics/topics/dvt.
  3. Herndon DN. Total Burn Care. 5th ed., Elsiever; 2018.
  4. Sarabhai S. ed. Principles and Practice of Burns. 1st ed., Jaypee Brothers; 2010.
  5. Williams N, Bulstrode C, et al. Bailey and Love's Short Practice of Surgery. 26th ed., Boca Raton: CRC Press; 2013. pp. 262–263.
  6. Bhat MS. SRB's Manual of Surgery. 5th ed., Jaypee Brothers Medical P; 2016.
  7. Naess IA, Christiansen SC. Incidence and mortality of venous thrombosis: a population based study. J Thromb Hemost 2007;5(4):692–699. DOI: 10.1111/j.1538-7836.2007.02450.x.
  8. Kahn SR. The clinical diagnosis of deep vein thrombosis: integrating incidence, risk factors and symptoms and signs. Arch Intern Med 1998;158(21):2315–2323. DOI: 10.1001/archinte.158.21.2315.
  9. Tovey C, Wyatt S. Diagnosis, investigation and management of Deep Vein Thrombosis Clinical Review. BMJ 2003;326:1180–1184. DOI: 10.1136/bmj.326.7400.1180.
  10. Goldhaber SZ. Pulmonary embolism. Lancet 2004;363:1295. DOI: 10.1016/S0140-6736(04)16004-2.
  11. Fecher AM, O’Mara MS, et al. Analysis of deep vein thrombosis in burn patients. Burns 2004 Sep;30(6):591–593. DOI: 10.1016/j.burns.2003.12.019.
  12. Mayon BT, Julian W, et al. Deep vein thrombosis in burns. Burns July 1981;7(6):438–400.
  13. Panucci CJ, Osborne NH. Venous thromboembolism in thermally injured patients. Analysis of the national burn repository. J Burn Care Res 2011;32:6–12. DOI: 10.1097/BCR.0b013e318204b2ff.
  14. Ahuja RB, Bansal P, et al. An analysis of deep vein thrombosis in burn patients: a randomized and controlled study of thromboprophylaxis with Low Molecular Weight Heparin. Burns 2016 Dec;42(8):1693–1698. DOI: 10.1016/j.burns.2016.08.007.
  15. Wahl WL, Brandt MM. Potential risk factors for deep evein thrombosis in burn patients. J Burn Care Rehabil 2001;22:128–131. DOI: 10.1097/00004630-200103000-00008.
  16. Wahl WL, Barandt MM, et al. Venous thrombus incidence in burn patients – Preliminary results of a prospective study. J Burns Care and Rehab 2002;23(2):206–210. DOI: 10.1097/00004630-200203000-00005.
  17. Ann L, Hoballah J, et al. The prevalence of venous thromboembolism of the lower extremity among thermally injured patients determined by duplex sonography. J Trauma 2003;55(6):1162–1167.
  18. Faucher CD, Lohlon KM. Practice guidelines for deep vein thrombosis in burns. J Burn Care Res 2007 Sep-Oct;285:661–663. DOI: 10.1097/BCR.0B013E318148C887.
  19. Lipe B, Ornstein DL. Deficiencies of natural anticoagulants, Protein C, protein S, and antithrombin. Circulation 2011;124(14):e365–e368. DOI: 10.1161/CIRCULATIONAHA.111.044412.
  20. Wells PS, Owen C. Does this patient have deep vein thrombosis? JAMA 2006 Jan 11;295(2):199–207. DOI: 10.1001/jama.295.2.199, (Discussion of Wells DVT score).
  21. Snow V, et al. Management of venous thromboembolism: A clinical practice guideline from the American College of Physicians and the American Academy of Family physicians. Ann Intern Med 2007;146(3):204–210. DOI: 10.7326/0003-4819-146-3-200702060-00149.
  22. Lederle FA, et al. Venous thromboembolism prophylaxis in hospitalized patients: A background review for an American College of Physicians clinical practice guideline. Ann Intern Med 2011;155(9):602–615. DOI: 10.7326/0003-4819-155-9-201111010-00008.
  23. Bates SM, Jaeschke R, et al. Diagnosis of DVT. Chest 2012 Feb;141(2):e351S–418S. DOI: 10.1378/chest.11-2299.
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