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Should mechanical VTE prophylaxis be indicated in all Asian patients who are contraindica... Recommendation Yes, mechanical VTE prophylaxis is the most appropriate VTE prevention in Asian patients who are contraindicated for pharmacological prophylaxis. This study, on 454 patients who underwent hip fracture surgery with mechanical prophylaxis in all cases, showed an overall DVT incidence of 6.4% (29 patients) and a PE incidence of 1.3% (6 patients) [[24]]. Should a mechanical device for VTE prophylaxis be routinely applied in Asian patients unde... Recommendation Yes, a mechanical device for VTE prophylaxis should routinely be applied in all Asian patients undergoing knee and hip arthroplasty and hip fracture surgery. The subgroup analysis found that 19 (0.8%) proximal DVTs and 83 (3.8%) distal DVTs developed in the patients without chemoprophylaxis, and 4 (0.7%) proximal DVTs and 28 (5.2%) distal DVTs developed in the patients with chemoprophylaxis [[18]]. [Extracted from the article]

Background: The treatment for deep surgical site infection (SSI) following primary total hip arthroplasty (THA) varies internationally and it is at present unclear which treatment approaches are used in Australia. The aim of this study is to identify current treatment approaches in Queensland, Australia, show success rates and quantify the costs of different treatments. Methods: Data for patients undergoing primary THA and treatment for infection between January 2006 and December 2009 in Queensland hospitals were extracted from routinely used hospital databases. Records were linked with pathology information to confirm positive organisms. Diagnosis and treatment of infection was determined using ICD-10-AM and ACHI codes, respectively. Treatment costs were estimated based on AR-DRG cost accounting codes assigned to each patient hospital episode. Results: A total of n=114 patients with deep surgical site infection were identified. The majority of patients (74%) were first treated with debridement, antibiotics and implant retention (DAIR), which was successful in eradicating the infection in 60.3% of patients with an average cost of $13,187. The remaining first treatments were 1-stage revision, successful in 89.7% with average costs of $27,006, and 2-stage revisions, successful in 92.9% of cases with average costs of $42,772. Multiple treatments following 'failed DAIR' cost on average $29,560, for failed 1-stage revision were $24,357, for failed 2-stage revision were $70,381 and were $23,805 for excision arthroplasty. Conclusions: As treatment costs in Australia are high primary prevention is important and the economics of competing treatment choices should be carefully considered. These currently vary greatly across international settings. [ABSTRACT FROM AUTHOR]