Clinical observation on the effect of low molecular weight heparin in preventing deep vein thrombosis in bedridden pa-tients undergoing skin-grafting

Ma Caihong; He Lixin; Cao Yujue; Tu Haixia; Li Donghai; Cao Peng; Liu Mi

doi:10.3969/j.issn.1672-8521.2014.02.010

Abstract：Objective:To observe the clinical effect of low molecular weight heparin (LMWH)on preventing deep vein thrombosis (DVT)in bedridden patients undergoing skin-grafting. Methods:Eighty-six patients with burn inj ury of both lower limbs or skin donor site on the thigh were randomly divided into two groups. The patients in the control group were given conventional therapy to prevent DVT,such as encouragement of constant contraction of muscles and active move-ment of toes. In the treatment group,5 000 IU LMWH was subcutaneously injected every evening from the fourth day after skin-graft in addition to above muscular contraction for 1 0 days. Automated latex immunoassay was used to assess plasma D-Dimmer 1 ,3 ,7 ,1 4 days postoperation. At the same time,the amount of platelets was monitored in the treat-ment group,and the healing time,and the survival rate of skin graft were compared between the two groups. Color Doppler echocardiography was used to detect DVT pre-operatively and 1 4 days postoperative. Results:Levels of D-Dim-mer increased on day 1 postoperation,and then it declined on day 3 in both groups. It remained normal on day 7 and 1 4 in the treatment group,but it increased in the control group,the difference between the two groups was statistically sig-nificant (P<0.05). No DVT was found in the lower limb of the treatment group with color Doppler echocardiography, but microthrombus in deep vein of lower limb was found in 1 patient in the control group. Healing time and the survival rate of skin grafts were similar between two groups (P>0.05),and no untoward effects of LMWH on platelets were ob-served. Conclusions:Subcutaneous inj ection of LMWH in patients undergoing skin grafting may have some clinical value in prevention and survellance of development of DVT after donation of skin grafts.