Dr Sivasuthan Goutham1, Dr Timothy Bussoletti1, Dr Jason Brown1
1Professor Stuart Pegg Adult Burns Unit, Royal Brisbane and Women’s Hospital
Unfractionated heparin has been the mainstay of chemoprophylaxis, however enoxaparin has increasingly been used in high-risk surgical patients. In this survey study we investigated current venous thromboembolism (VTE) chemoprophylaxis in major burns centres across Australia and New Zealand.
A phone survey was conducted at 10 sites registered with the Australia and New Zealand Burns Association (ANZBA). Information was gathered about each site’s current VTE prophylaxis protocol and any plans for future changes. Attempts were made to obtain further information about VTE rates at each unit, however due to discrepancies in VTE reporting, this data was not included.
Enoxaparin 40 mg subcutaneously once a day was used as VTE chemoprophylaxis in the Royal Darwin, North Shore, Alfred, Royal Adelaide, Royal Hobart, Fiona Stanley, Middlemore and Christchurch Hospitals. Royal Brisbane and Women’s and Concord Hospitals used unfractionated heparin 5000 units twice a day. All sites using enoxaparin have no plans to change their protocol.
Our study shows a lack of consistency in VTE prophylaxis across ANZBA sites. Burns patients have a unique risk profile for VTE including an elevated inflammatory state, multitrauma, significant immobility, intensive care unit stay and prolonged length of ventilation (Pannucci et al. 2012). There is a lack of consistency in VTE risk stratification and prophylaxis for burns patients, which may be aided by expansion of the current binational Burns Registry of Australia and New Zealand database to include VTE complications.
Dr Goutham Sivasuthan and Dr Timothy Busoletti are resident medical officers at the Royal Brisbane and Women’s Hospital who are pursuing a career in surgical training. They have keen interests in the development of safety processes and teaching.