Application of standardized venous thromboembolism prevention program in burn patients_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Yanqiong , HUANG Jianqiong ,  XU Xuewen ,  CHEN Junjie , WU Zhihui , GAO Jiali , TANG Jing , HU Min , YU Xia

Department of Aesthetic Plastic and Burn Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding?author：

XU Xuewen, Email: xxw_0286@163.com; CHEN Junjie, Email: cjjemail@163.com

Keywords：

Venous thromboembolism; burn; prevention; complication

DOI：

10.7507/1002-1892.201812061

Video：

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Objective To develop a standardized venous thromboembolism (VTE) prevention program for burn patients and verify its safety and effectiveness by comparing with traditional thrombus prophylaxis.Methods All burn patients admitted and met selection criteria betweem April 2017 and September 2018 were included. Patients between January 2018 and September 2018 were included as the interventional group to implement standardized VTE prevention programs, while patients between April 2017 and December 2017 were included as the control group and traditional active and passive exercises were used to prevent VTE. There was no significant difference in the age, gender, ethnic group, marriage, education, occupation, type and site of the injury, burn area, operation time, and hospital stay between the two groups (P>0.05), which was comparable. The incidence of VTE, number of cases of tissue or organ hemorrhage, survival rate of skin grafting, and time of wound healing were compared.Results The incidence of VTE was obviously lower in the interventional group (1.56%, 1/64) than in the control group (10.17%, 6/59) (χ²=?2.05, P=0.04). No bleeding occurred in any tissue or organ in the two groups. The survival rate of skin grafting and the time of wound healing were 89.06% (57/64) and (11.78±3.08) days respectively in the interventional group and 91.53% (54/59) and (11.66±2.30) days respectively in the control group; and the differences between the two groups were not statistically significant (χ²=0.21, P=0.65; t=?0.22, P=0.83).Conclusion The standardized VTE prevention program can effectively prevent the occurrence of VTE, and its safety is relatively high.

Citation： WANG Yanqiong, HUANG Jianqiong, XU Xuewen, CHEN Junjie, WU Zhihui, GAO Jiali, TANG Jing, HU Min, YU Xia. Application of standardized venous thromboembolism prevention program in burn patients. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(6): 726-729. doi: 10.7507/1002-1892.201812061 Copy

1.	Office of the Surgeon General (US), National Heart, Lung, and Blood Institute (US). The surgeon general’s call to action to prevent deep vein thrombosis and pulmonary embolism. Office of the Surgeon General (US), 2008.
2.	Goldhaber SZ. Evolving concepts in thrombolytic therapy for pulmonary embolism. Chest, 1992, 101(4 Suppl): 183S-185S.
3.	Abedi N, Papp A. A survey of current practice patterns in prophylaxis against venous thromboembolism (VTE) and gastrointestinal (GI) ulceration among Canadian burn centers. Burns, 2011, 37(7): 1182-1186.
4.	Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest, 2008, 133(6 Suppl): 381S-453S.
5.	Wahl WL, Brandt MM, Ahrns KS, et al. Venous thrombosis incidence in burn patients: preliminary results of a prospective study. J Burn Care Rehabil, 2002, 23(2): 97-102.
6.	Faucher LD, Conlon KM. Practice guidelines for deep venous thrombosis prophylaxis in burns. J Burn Care Res, 2007, 28(5): 661-663.
7.	Bouras G, Burns EM, Howell AM, et al. Risk of post-discharge venous thromboembolism and associated mortality in general surgery: A population-based cohort study using linked hospital and primary care data in England. PLoS One, 2015, 10(12): e0145759.
8.	Khalafallah AA, Kirkby BE, Wong S, et al. Venous thromboembolism in medical patients during hospitalisation and 3 months after hospitalisation: a prospective observational study. BMJ Open, 2016, 6(8): e012346.
9.	高鳳英, 習耀鋒, 鄭明霞, 等. 燒傷患者深靜脈血栓發生情況及其影響因素. 中華燒傷雜志, 2016, 32(3): 176-180.
10.	Guyatt GH, Akl EA, Crowther M, et al. Executive summary: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(2 Suppl): 7S-47S.
11.	范寶玉, 王娟, 趙海磊. 皮下注射低分子肝素鈣對燒傷植皮后深靜脈血栓形成、創面愈合及感染率的影響. 感染、炎癥、修復, 2017, 18(3): 141-144.
12.	馬彩虹, 賀立新, 曹玉玨, 等. 皮下注射低分子肝素鈣預防燒傷植皮后深靜脈血栓形成的臨床觀察. 感染、炎癥、修復, 2014, 15(2): 98-100.
13.	Bushwitz J, LeClaire A, He J, et al. Clinically significant venous thromboembolic complications in burn patients receiving unfractionated heparin or enoxaparin as prophylaxis. J Burn Care Res, 2011, 32(6): 578-582.
14.	Lin H, Faraklas I, Saffle J, et al. Enoxaparin dose adjustment is associated with low incidence of venous thromboembolic events in acute burn patients. J Trauma, 2011, 71(6): 1557-1561.
15.	Henke PK, Arya S, Pannucci C, et al. Procedure-specific venous thromboembolism prophylaxis: a paradigm from colectomy surgery. Surgery, 2012, 152(4): 528-534.
16.	Turpie AG, Bauer KA, Caprini JA, et al. Fondaparinux combined with intermittent pneumatic compression vs. intermittent pneumatic compression alone for prevention of venous thromboembolism after abdominal surgery: a randomized, double-blind comparison. J Thromb Haemost, 2007, 5(9): 1854-1861.
17.	Pannucci CJ, Obi AT, Timmins BH, et al. Venous thromboembolism in patients with thermal injury: A review of risk assessment tools and current knowledge on the effectiveness and risks of mechanical and chemical prophylaxis. Clin Plast Surg, 2017, 44(3): 573-581.
18.	Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest, 2016, 149(2): 315-352.
19.	張競, 張金慶, 郭盛杰, 等. 不同頻次使用間歇式充氣加壓裝置對預防關節置換術后下肢深靜脈血栓形成的效果研究. 中華骨與關節外科雜志, 2016, 9(4): 335-338.
20.	Bolliger D, Szlam F, Azran M, et al. The anticoagulant effect of protamine sulfate is attenuated in the presence of platelets or elevated factor Ⅷ concentrations. Anesth Analg, 2010, 111(3): 601-608.
21.	王國棟, 張元民, 趙曉偉, 等. 利伐沙班對初次行人工全膝關節置換術后隱性失血及輸血率的影響. 中國修復重建外科雜志, 2012, 26(11): 1306-1309.
22.	Kahn SR, Lim W, Dunn AS, et al. Prevention of VTE in nonsurgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(2 Suppl): e195S-e226S.

1. Office of the Surgeon General (US), National Heart, Lung, and Blood Institute (US). The surgeon general’s call to action to prevent deep vein thrombosis and pulmonary embolism. Office of the Surgeon General (US), 2008.
2. Goldhaber SZ. Evolving concepts in thrombolytic therapy for pulmonary embolism. Chest, 1992, 101(4 Suppl): 183S-185S.
3. Abedi N, Papp A. A survey of current practice patterns in prophylaxis against venous thromboembolism (VTE) and gastrointestinal (GI) ulceration among Canadian burn centers. Burns, 2011, 37(7): 1182-1186.
4. Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest, 2008, 133(6 Suppl): 381S-453S.
5. Wahl WL, Brandt MM, Ahrns KS, et al. Venous thrombosis incidence in burn patients: preliminary results of a prospective study. J Burn Care Rehabil, 2002, 23(2): 97-102.
6. Faucher LD, Conlon KM. Practice guidelines for deep venous thrombosis prophylaxis in burns. J Burn Care Res, 2007, 28(5): 661-663.
7. Bouras G, Burns EM, Howell AM, et al. Risk of post-discharge venous thromboembolism and associated mortality in general surgery: A population-based cohort study using linked hospital and primary care data in England. PLoS One, 2015, 10(12): e0145759.
8. Khalafallah AA, Kirkby BE, Wong S, et al. Venous thromboembolism in medical patients during hospitalisation and 3 months after hospitalisation: a prospective observational study. BMJ Open, 2016, 6(8): e012346.
9. 高鳳英, 習耀鋒, 鄭明霞, 等. 燒傷患者深靜脈血栓發生情況及其影響因素. 中華燒傷雜志, 2016, 32(3): 176-180.
10. Guyatt GH, Akl EA, Crowther M, et al. Executive summary: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(2 Suppl): 7S-47S.
11. 范寶玉, 王娟, 趙海磊. 皮下注射低分子肝素鈣對燒傷植皮后深靜脈血栓形成、創面愈合及感染率的影響. 感染、炎癥、修復, 2017, 18(3): 141-144.
12. 馬彩虹, 賀立新, 曹玉玨, 等. 皮下注射低分子肝素鈣預防燒傷植皮后深靜脈血栓形成的臨床觀察. 感染、炎癥、修復, 2014, 15(2): 98-100.
13. Bushwitz J, LeClaire A, He J, et al. Clinically significant venous thromboembolic complications in burn patients receiving unfractionated heparin or enoxaparin as prophylaxis. J Burn Care Res, 2011, 32(6): 578-582.
14. Lin H, Faraklas I, Saffle J, et al. Enoxaparin dose adjustment is associated with low incidence of venous thromboembolic events in acute burn patients. J Trauma, 2011, 71(6): 1557-1561.
15. Henke PK, Arya S, Pannucci C, et al. Procedure-specific venous thromboembolism prophylaxis: a paradigm from colectomy surgery. Surgery, 2012, 152(4): 528-534.
16. Turpie AG, Bauer KA, Caprini JA, et al. Fondaparinux combined with intermittent pneumatic compression vs. intermittent pneumatic compression alone for prevention of venous thromboembolism after abdominal surgery: a randomized, double-blind comparison. J Thromb Haemost, 2007, 5(9): 1854-1861.
17. Pannucci CJ, Obi AT, Timmins BH, et al. Venous thromboembolism in patients with thermal injury: A review of risk assessment tools and current knowledge on the effectiveness and risks of mechanical and chemical prophylaxis. Clin Plast Surg, 2017, 44(3): 573-581.
18. Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest, 2016, 149(2): 315-352.
19. 張競, 張金慶, 郭盛杰, 等. 不同頻次使用間歇式充氣加壓裝置對預防關節置換術后下肢深靜脈血栓形成的效果研究. 中華骨與關節外科雜志, 2016, 9(4): 335-338.
20. Bolliger D, Szlam F, Azran M, et al. The anticoagulant effect of protamine sulfate is attenuated in the presence of platelets or elevated factor Ⅷ concentrations. Anesth Analg, 2010, 111(3): 601-608.
21. 王國棟, 張元民, 趙曉偉, 等. 利伐沙班對初次行人工全膝關節置換術后隱性失血及輸血率的影響. 中國修復重建外科雜志, 2012, 26(11): 1306-1309.
22. Kahn SR, Lim W, Dunn AS, et al. Prevention of VTE in nonsurgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(2 Suppl): e195S-e226S.

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Application of standardized venous thromboembolism prevention program in burn patients

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