How to Avoid Blood Clots After Surgery

Jul 16, 2018

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Following any type of major surgery, including joint replacement surgery, you are at an increased risk for developing blood clots. A blood clot forms when the platelets in your blood clump together to form a gel-like mass. This occurs normally in the body if you are bleeding, such as from a cut or wound, but when clotting occurs within your blood vessels it can block the flow of blood.

The most common type of blood clot is called a deep vein thrombosis (DVT) and forms in the deep veins of your body, usually in the lower leg. A pulmonary embolism (PE) forms when a blood clot from somewhere in the body dislodges, travels to your lungs, and causes a blockage in one of the arteries of your lungs. This can cause serious complications and is life threatening.

Signs of a DVT in the lower leg include swelling, change in color, warmth, itching, and pain. Signs of a PE include shortness of breath and trouble breathing, chest pain, coughing, sweating, and dizziness.

After surgery, you are at an increased risk for blood clots because you are less mobile. Your legs and muscles are not working as much and a significant proportion of your time is spent lying in bed. This leads to stagnation of the blood in your veins. The flow of blood is slower and less blood is being pumped back to the heart. This makes it easier for blood clots to form.

Thankfully, many preventive measures are taken after your surgery that help significantly reduce the risk of developing blood clots. Some important preventive measures include the following:

Anti-coagulation therapy:

Specific medications are used to help decrease the ability of your blood to form clots. The most common medication is Heparin, which is commonly taken via an IV. Usually, you are then transitioned to taking the medicine Warfarin (coumadin or similar), which can be taken orally.

Compression stockings:

These are stockings that are worn around the feet and lower legs and provide a constant moderate compression of the legs. This helps increase the movement of blood in the veins and its return to the heart.

Elevating the extremity:

Elevating the legs can help take advantage of the effects of gravity and increase venous blood flow to the heart.

Sequential compression devices:

These devices are sleeves that wrap around the lower legs and alternate between filling with air to compress the leg and then letting the air out to release the compression. This also helps improve blood flow within the legs.

Leg exercises:

When the muscles in your legs contract, they act as a pump that pushes the blood from your veins back towards your heart. Easy exercises to do while laying in bed after surgery include ankle pumps, heel slides, and supine marching.

Early mobility:

Arguably, the best way to prevent blood clots is limiting the amount of immobility and bed rest after surgery through early mobility. This includes sitting up, standing, and walking very early after your surgery (with the appropriate supervision and guidance).

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