Deep vein thrombosis

Deep Vein Thrombosis (DVT) is the formation of a blood clot in the deep veins of the legs. The blood clot can break off and travel in the blood stream to the lungs as a pulmonary embolism (PE). Pulmonary embolism can cause problems with breathing, blood flow in the lungs and can even be fatal. Prior to undergoing surgery, it is appropriate to have perspective on DVT, its causes and risk factors and what you can do to minimise the chance of its occurrence.

The risk factors for DVT are:

  1. Long haul flights
  2. Surgery: major surgery, abdominal surgery
  3. Previous DVT or PE
  4. Patient age (increase risk with increased age)
  5. Obesity
  6. Disease (diabetes mellitus, cardiac disease, respiratory disease, polycythemia)
  7. Medication: oral contraceptive pill
  8. Pregnancy
  9. Cancer

Preventative measures:

  1. Avoid risk factors such as the oral contraceptive pill, etc. If you are on the pill, I recommend stopping it one month prior to surgery. Don't forget to take other contraceptive measures!
  2. Stop smoking: Not only does smoking increase the risk of DVT, but it also increases the risk of other complications.
  3. Graduated compression stockings such as TED stockings can be obtained prior to your departure from home, used on the aeroplane coming over, and during and after surgery. This is well worth doing and I would urge all patients traveling from abroad for surgery to do this.
  4. Exercise routinely post op and on the flights here and home. Every hour on the hour: knee bends, ankle movements, wiggle toes. Walk around. Follow the guidelines in the in-flight magazine.
  5. Avoid sleeping pills and alcohol on the flight.
  6. Drink plenty of fluids, water in particular.
  7. All patients will receive treatment in theatre with graduated pressure calf/foot pumps.
  8. High risk patients should avoid traveling for surgery. The use of Clexane injections prior to flying and before and after surgery are useful.