The use of thromboembolic prophylaxis in oral and maxillofacial surgery

Objectives—To investigate the use of thromboembolic prophylaxis in oral and maxillofacial surgery. Design—Postal questionnaire. Setting—Oral and maxillofacial surgery departments in the UK. Subjects—Consultant Oral and Maxillofacial surgeons as listed in the BAOMS Handbook of Hospitals, Oral and Maxillofacial Surgery. Main outcome measures—Factors used in the decision to use thromboembolic prophylaxis and the methods of prophylaxis used. Results—The response rate was 73%. Previous thromboembolism (85% of respondents), prolonged immobilisation (79%) and length or magnitude of operation (78% and 74%) were the most commonly used risk factors, in the decision to use prophylaxis against DVT. Pre-operative trauma, cardiovascular disease and varicose veins were the risk factors most infrequently used. No forms of prophylaxis were used by 18% of respondents, with the remaining respondents using a variety of methods. The most widely used methods were graduated elastic compression stockings (74%) and low dose subcutaneous heparin (73%). Conclusion—The majority of known risk factors were taken into account when considering the use of prophylaxis against DVT. The methods of thromboembolic prophylaxis used in oral and maxillofacial surgery are considered to provide a satisfactory degree of protection, in moderate and low risk patient groups.