Continuing my theme on blood clots and why we care, you can read all my blogs on the subject HERE.
In surgery we care a lot about a blood clot in your leg. Not because of the clot in the leg which can cause leg swelling and some pain, but because if that clot dislodges, it travels through the veins and lands in the lung. It then prevents your lung from exchanging oxygen. If the clot is big enough, you don’t get enough oxygen. With no oxygen you can die.
So.
I score your risk prior to surgery using the Caprini risk score. We use compression devices during surgery to circulate your blood in your legs. We put pillows behind your knee to help blood flow. We get you out of bed early after surgery so the blood moves around. But there is always risk.
Come in the Wells score. Anything 3 or higher puts you at higher likelihood for a DVT. (To diagnose a DVT you would want to have an ultrasound to look for the clot.)
Wells score:
- Active cancer treatment or palliation within 6 months SCORE 1
- Bedridden recently >3 days or major surgery within 12 weeks SCORE 1
- Calf swelling >3 cm compared to the other leg Measured 10 cm below tibial tuberosity SCORE 1
- Collateral (nonvaricose) superficial veins present SCORE 1
- Entire leg swollen SCORE 1
- Localized tenderness along the deep venous system SCORE 1
- Pitting edema, confined to symptomatic leg SCORE 1
- Paralysis, paresis, or recent plaster immobilization of the lower extremity SCORE 1
- Previously documented DVT SCORE 1
- Alternative diagnosis to DVT as likely or more likely SCORE -2