- Title
- An evaluation of the appropriate use of intermittent compressions devices and beneficial cost saving in health for venous thromboembolism (VTE) prophylaxis in major abdominal surgery
- Creator
- Lott, Natalie Jane
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2025
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- The global incidence of postoperative mortality is high, with up to 4.2 million deaths occurring within 30 days following surgery annually, primarily attributed to complications such as venous thromboembolism (VTE). VTE, which includes Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE), represents a significant yet preventable postoperative complication. It arises from a complex interplay of factors that disrupt the balance between coagulation and anticoagulation processes in the blood. International and Australian VTE guidelines have evolved, aiming to standardise VTE prophylaxis practices. However, the implementation of these guidelines varies, reflecting a blend of evidence- based recommendations and clinical judgement. This thesis critically examines the evidence supporting the use of mechanical prophylaxis in surgical patients, specifically Intermittent Pneumatic Compression Devices (IPCDs), assessing their effectiveness and prophylactic strategies. The literature was reviewed relating to the use of IPCDs in major abdominal surgery and what this means in the progressive surgical setting. The thesis addresses the following five questions: 1. How effective are IPCDs? What is the quality of the evidence supporting their use and the potential gaps in this evidence? 2. What is the opinion and current practice of surgeons in Australia and New Zealand on IPCD use? 3. What are the current institutional (hospital) VTE prophylactic measures? 4. What are surgical nurses’ opinions and practices about VTE risk assessment and prophylaxis? 5. How and what further research should be generated to address evidence gaps about IPCD effectiveness and value? The culmination of this thesis has been the design and implementation of a major multi-centre randomised controlled trial (The IMPOSTERS Trial), assessing the efficacy, value, cost and potential waste of the addition of IPCDs to standard care for the prevention of VTE following major surgery. This trial has received significant public (NSW TRGS Au$495,000) and private (RHRF Au$374,000) grant funding and has commenced in 6 major hospitals in NSW.
- Subject
- venous thromboembolism; major abdominal surgery; intermittent pneumatic compression devices; low molecular weight heparing; graduated compression stockings; deep vein thrombosis; pulmonary embolism
- Identifier
- http://hdl.handle.net/1959.13/1520239
- Identifier
- uon:57447
- Rights
- Copyright 2025 Natalie Jane Lott
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 5 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 397 KB | Adobe Acrobat PDF | View Details Download |