Drain tube removal in the presence of anticoagulation in Spinal Surgery

Venous thromboembolism (VTE), the collective term for Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE), remains a major cause of morbidity and a significant cause of mortality in hospitalised patients across Australia and internationally. It is important that adequate prophylaxis is provided for patients at risk. Measures including; anti-clotting medication, graduated compression stockings, adequate hydration and early mobilisation are known to be effective in reducing the incidence of VTE.

The prevention of VTE in acute care hospitals has been recognised worldwide as a priority patient safety issue because of the strong evidence base for preventive measures and high potential for improvements in patient outcomes.

With the introduction of risk assessment tools identifying patients of increased risk of VTE, more neurosurgical patients are now receiving VTE prophylaxis during their postoperative clinical course. This raises the question of the role and the impact of VTE anticoagulation when it comes to surgical drain tube removal and the risk of bleeding after spinal surgery. With multiple neurosurgeons and a variety of opinions, the clinical nursing team decided to review the role of anticoagulation and drain tube removal through evidence based research.