This document discusses thrombosis (blood clots) and thromboembolism. It explains that thrombosis can form during or after surgery when blood pools and clots more easily. Surgeries that involve the legs, hips, pelvis or abdomen carry higher risk. Signs of deep vein thrombosis (DVT) include leg pain and swelling. Prevention methods include blood thinners, leg exercises and compression stockings. The aim of the project was to accurately assess risks of venous thromboembolism during surgery and ensure proper preventative measures to decrease incidents and enhance recovery.

1. SMOLENSK STATE MEDICAL
UNIVERSITY
PRESENTED BY Avtansh Gupta
GROUP 501

2. Normal Haemostasis
 Process of maintaining blood in a fluid, clot – free state in normal vasculature and rapidly forming a
localized haemostatic plug at the site of vascular injury
 The pathologic opposite of haemostasis is thrombosis

4. Thrombosis
 Formation of solid mass in circulation from constituents of flowing blood with intact cardiovascular
tree during life.

13.  Superficial thrombosis is known as thrombophlebitis or phlebitis a clot that develop on surface of
skin.
 Deep vein thrombosis is the formation of a blood clot in one of the deep vein of the body usually
leg.
 Deep Venous Thrombosis Lower extremity DVT usually begins in the calf and propagates
proximally to the popliteal vein, femoral vein, and iliac veins.
 Leg DVT is about 10 times more common than upper extremity DVT, which is often precipitated by
placement of pacemakers, internal cardiac defibrillators, or indwelling central venous catheters.
 Superficial venous thrombosis usually presents with erythema, tenderness, and a “palpable cord.”
Patients are at risk for extension of the thrombosis to the deep venous system.

21. When can thrombosis formed?
 While a clot can form after any type of procedure, like any major surgery, particularly on
your abdomen, pelvis, hips, or legs.
 Some specific operations that come with a high risk for DVT and PE are:
• Knee or hip replacement
• Peripheral and coronary artery bypass
• Surgery to remove cancer
• Neurosurgery
• Surgery on your abdomen
• Other major operations

22. Why It Happens?
 Surgeries raise risk for DVT because staying in bed for long periods of time while recovery. When
patient stop moving, blood flows more slowly in deep veins, which can lead to a clot. Other
surgery–related factors that may increase risk for blood clots include:
 How extensive or long the procedure was
 The way you had to be positioned during surgery
 The type of anesthesia used
 most likely to form a clot between 2 and 10 days after surgery.

23. During Surgery
 Sometimes, the surgery itself can cause a blood clot. Long procedures when lying on the operating
table for many hours allow blood to settle and pool, which makes it easier to clot. Major surgeries
like cancer and heart bypass operations tend to take longer, which is one reason they’re higher risk
for DVT.
 Tissue, debris, fat, or collagen could get released into blood system during an operation, making
blood thicker around those particles. Blood clots can also form if veins are damaged during an
operation.
 Surgeries that involve scraping or cutting into a bone, such as a hip replacement, may release
substances known as antigens. These antigens trigger body's immune system and can lead to clots.

24. greater chance of DVT after surgery when:
• Smoke
• Had DVT in the past
• Are overweight or obese
• Have close family members with DVT
• Are pregnant
• Have a disorder that affects your blood or veins
• Are older
• Use certain medicines, including birth control and hormone therapy
• Have specific types of cancer

25. signs of DVT or PE:
 Pain or tenderness in your leg
• Swelling or warmth in your leg
• Red or discolored skin on your leg
• Veins that stick out
• Shortness of breath
• Coughing up blood
• Sudden chest pain
• Painful breathing

29. Physical examination

30. D-dimer assay

32. Non invasive imaging modalities
 VENOUS ULTRASONOGRAPHY
 MRI
 CONTRAST PHLEBOGRAPHY

33. Dvt score

34. Well’s criteria for dvt

36. How to Help Prevent DVT Before Surgery?
 Quit Smoke.
 Work on getting rid of any extra pounds you're carrying, too.
 Try to loss weight.

37. How to Lower Chances for DVT After Surgery?
 Anticoagulants. They make it harder for your blood cells to stick together and form clots. You take
them by mouth, shot, or through an IV
 Simple movements. These can improve blood flow. Depending on the type of surgery you had, your
care team might suggest gentle exercises like:
o Leg lifts while you're in bed
o Moving your feet in a circle or up and down about 10 times an hour while you’re sitting in a chair or
lying in bed
o Squeezing your calf and thigh muscles regularly
 Elastic compression stockings

46. embolism

49. Pulmonary thromboembolism

51. Fat embolism

53. Air embolism

55. Amniotic fluid embolism

58. Initial treatment for thromboembolism

59. Abstract
 Objectives: This project's aim was to ensure that venous thromboembolism assessment was
performed accurately, and that adequate prophylaxis was followed-up, resulting in a decrease in the
incidence of venous thromboembolism postoperatively and enhancing recovery after surgery.
 Conclusions: Overall the project achieved a significant improvement in evidence-based practice in
the prevention of VTE, implemented in two wards. Sustaining best practice should be planned for
the future.

60. Thank you