Dermatan sulphate: A safe approach to prevention of postoperative deep vein thrombosis
- 1 June 1992
- journal article
- clinical trial
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 79 (6) , 505-509
- https://doi.org/10.1002/bjs.1800790610
Abstract
To assess the eficacy and safety of dermatan sulphate (MF 701) in preventing postoperative deep vein thrombosis (DVT), 324 patients aged 40 years or over undergoing elective major general surgical operations were included in a randomized trial comparing MF 701 (100 my intramuscularly once a day) with unfractionated calcium heparin ( UFH, 5000 units subcutaneously three times daily). Both treatments were initiated before operation and continued until discharge. In all, 316 patients were included in the analysis (MF 701, 157; UFH, 159). Serial impedance plethysmography was performed in all patients; a 125I‐radiolabelled fibrinogen uptake test was added to impedance plethysmography in a randomized subsample of 62 patients (MF 701, 28; UFH, 34). Positivity in either test was confirmed where possible by venography. DVT was diagnosed by venography or, when this could not be performed, by positivity of either impedance plethysmography or fibrinogen uptake test. The incidence of DVT was 3.1 per cent (patients receiving MF 701) and 1.6 per cent (those receiving UFH) in patients undergoing impedance plethysmography alone, and 7.1 and 11.8per cent, respectively, in those undergoing both impedance plethysmography and fibrinogen uptake test; in neither case was the difference between treatments statistically significant. There were five in‐hospital deaths, two in patients receiving MF 701 and three in patients on UFH. The incidence of clinically overt haemorrhage was 5.7 per cent in patienis on MF 701 and 17.6 per cent in those on UFH (P < 0.01). Postoperative transfusions and reoperations due to bleeding were significantly less frequent in patients receiving MF 701. Mortality rates at 3 months were similar for the two treatment groups. Compared with standard prophylaxis using UFH, MF701 showed a similar eficacy with a significantly greater safety.Keywords
This publication has 28 references indexed in Scilit:
- Current status of the clinical use of heparin fractionsLa Ricerca in Clinica e in Laboratorio, 1989
- Reduction in Fatal Pulmonary Embolism and Venous Thrombosis by Perioperative Administration of Subcutaneous HeparinNew England Journal of Medicine, 1988
- Clinical studies with low-molecular-weight heparin(oid)s: An interim analysisAmerican Journal of Hematology, 1988
- Clinical Use of Low Molecular Weight Heparins and HeparinoidsSeminars in Thrombosis and Hemostasis, 1988
- Prevention of Venous Thrombosis and Pulmonary EmbolismPublished by American Medical Association (AMA) ,1986
- Subcutaneous Heparin and Postoperative Wound HematomasArchives of Surgery, 1986
- Subcutaneous heparin, plasma heparin levels and postoperative wound haematomaBritish Journal of Surgery, 1984
- PREVENTION OF VENOUS THROMBOEMBOLISMThe Lancet, 1980
- Low Dose HeparinAnnals of Surgery, 1977
- PREVENTION OF FATAL POSTOPERATIVE PULMONARY EMBOLISM BY LOW DOSES OF HEPARINObstetrical & Gynecological Survey, 1976