Steps To Prevent Blood Clots After Surgery

Blood Clot After Joint Replacement

blood clot
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Blood clots are a possible complication of any major surgery, including hip replacement and knee replacement.  When a blood clot occurs in the large veins of the legs it can cause symptoms of pain and swelling.  This is a condition called a deep vein thrombosis, or DVT, for short. Furthermore, there is a small chance of the blood clot breaking free, and traveling through the veins and into the lungs.  This is a condition called a pulmonary embolism, and can be a serious complication causing shortness of breath and even death.

The good news is that there are several steps that can be taken to lower the chance of a blood clot from occurring.  While the risk of a DVT is never zero, patients can take steps to prevent blood clots and lower the chance of complication.  The best advice is to not rely on any one treatment or intervention to lower the chance of blood clot, and instead take different steps to limit the chance of a DVT from occurring.  This means that even if you are on a blood thinning medication, you should still take other steps to prevent blood clots.

Get Moving

patient surgery moving
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The best advice for patients after any major surgery is to get up and get moving.  This can be difficult for many reasons: pain, nausea, tubes, and other problems can inhibit normal movement.  But the best way to prevent blood clots that you can control is how much you move.  If you can't get out of bed, there are some simple activities including foot pumps and knee bends that you can do while lying in your bed to improve your circulation.

Wear Compression Stockings

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Compression stockings are worn on the legs to help prevent venous stasis, a condition where blood pools in the veins of the legs.  The compression socks come in a variety of lengths and many different levels of compression.  Many patients find the stockings uncomfortable and difficult to put on and take off. 

Compression stockings generally don't need to be worn all the time, and taking breaks from the stockings can help patients tolerate their use.  If the stockings are too uncomfortable, try one that has less compression to see if that makes them more tolerable.  As patients become more active, compression stockings are generally not needed as much.  Discuss with your doctor how long you should wear compression stockings after your surgical procedure.

Mechanical Pumps

foot pumps
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Compression pumps are wrapped around the foot or legs and a pump squeezes compressed air into the sleeve to gently pump the veins in the feet or legs.  While this has an effect on actually squeezing blood in the veins, it also causes the body to release natural anti-clotting molecules into your blood stream.  Interestingly, wearing a compression boot on only one leg can help to prevent blood clots in the other leg--this is because the compression stimulates the body to prevent blood clots throughout your circulatory system.

The most annoying aspect of mechanical compression boots are the audible 'puff' that occurs each time the machine pushes compressed air into the sleeve.  For a patient trying to sleep, this is sometimes an annoyance, but like wearing the compression socks, can be treated by taking short breaks from use of the machine.  Most often patients only use the mechanical pumps in the hours and days after major surgery, like joint replacement, when they are in the hospital.

Blood Thinning Medications

injection pills
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There are a number of different medications that can be used to prevent blood clot formation.  The trick is, that any of these medications can also cause an increased risk of bleeding, and therefore it is important to balance the risk of developing a DVT with the possibility of spontaneous bleeding from being on one of these medications. 

Some blood thinning medications are injected (heparin, lovenox) and others are taken by mouth (coumadin, xarelto, aspirin).  Some medications require regular monitoring of the level of blood thinning (heparin, coumadin).  On top of that some medications are cheap (coumadin, aspirin), while others can be very expensive (xarelto, lovenox).  Because of these different characteristics, your doctor may prefer one medication type over another. 

No matter what type of blood thinning medication has been recommended for you, it is important to follow your surgeon's directions and immediately alert your doctor of any unusual symptoms or bleeding.

Other Risk Factors

quit smoking
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There are many risk factors for developing a blood clot.  Some of these you can control, others you can't.  Your doctor can help you understand if there are any particular concerns based on your health history that may help you prevent this complication.

One concern that is controllable is smoking.  It is well known that tobacco use can increase the risk of developing a blood clot.  Quitting smoking can help you prevent blood clots, as well as reduce the risk of other complications from joint replacement sugery.

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