Non-pharmacological Methods of Deep Vein Thrombosis Prophylaxis in Orthopaedic Wards.

Deep vein thrombosis (DVT) is a dreaded post-operative complication for surgeons and warrants prophylactic measures. The risk of DVT is significantly higher in almost any and all major surgery. The common prophylactic measures are pharmacological methods like subcutaneous low-molecular-weight heparin and oral anticoagulants. In some cases, these are contraindicated due to the risk of post-operative bleeding and wound soakage. In the editorial, we discuss the non-pharmacological methods of DVT prophylaxis in the form of basic physiotherapy. In our orthopaedic wards, we initiate basic physiotherapy like static hamstring, quadriceps exercises and ankle pumps. These exercises work by preventing the pooling of blood in the lower limbs, thereby hypothesized to prevent DVT. We have been implementing this method in all patients; hence, it has a universal application. It is cost-effective and does not have any adverse reactions. However, its use has some limitations, such as in patients with lower limb ankle fractures, polytrauma patients who are intubated, spinal cord injury patients with power loss and patients with neurological injury, although this cohort is a smaller fraction of the patients undergoing orthopaedic surgical intervention. In our experience, this method is an excellent non-pharmacological method of DVT prophylaxis which is easy to implement, is universally applicable, does not require any major special instrumentation or infrastructure and is cost-effective for the patient as well as the hospital.