<h4>Background</h4>Deep vein thrombosis (DVT) poses a significant health risk, particularly in hospitalized patients with multiple risk factors (cigarette smoking, hypertension, diabetes and obesity). Despite advances in treatment, DVT remains a prevalent complication of hospitalization.<h4>Objective</h4>To assess the effectiveness of non-instrumental mobilization in hospitalized patients at high risk of DVT, exploring the challenges and variations in intervention protocols.<h4>Design</h4>Systematic review and meta-analysis.<h4>Setting(s)</h4>Not applicable.<h4>Participants</h4>Hospitalized patients at risk of deep vein thrombosis.<h4>Methods</h4>A systematic search of three databases was conducted from interception to September 2023 for randomized controlled trials. This study was registered in PROSPERO (CRD42023460485). This study was conducted according to PRISMA 2020 statement. Two authors independently screened the studies and extracted the data. The quality of the studies was evaluated using the Downs and Black checklist and GRADE system. The amount of evidence certainty was assessed using the Cochrane Risk of Bias Assessment tool. Meta-analysis was performed addressing the incidence of deep vein thrombosis during hospitalization.<h4>Results</h4>7 studies were eligible for inclusion which included a total of 1774 participants. Interventions ranged from active and passive ankle exercises to walking. Meta-analysis demonstrated a significant overall effect in favor of non-instrumental early mobilization compared to usual care (RR = 0.55; 95 % CI = 0.41, 0.73; p < 0.0001). Subgroup analysis comparing type of mobilization revealed significant effects for global (RR = 0.54; 95 % CI = 0.38, 0.78; p = 0.001) and remote mobilization (RR = 0.25; 95 % CI = 0.07, 0.86; p = 0.03).<h4>Conclusions</h4>Non-instrumental early mobilization is beneficial in reducing the incidence of deep vein thrombosis in hospitalized patients.<h4>Registration</h4>PROSPERO, registration number: CRD42023460485.

Deep vein thrombosis (DVT) is a common and serious complication following lower limb orthopaedic surgery. Early ankle pump exercises may promote venous return, reduce limb swelling, and lower the incidence of postoperative DVT. However, the efficacy of such interventions remains inconsistently reported. The aim of this meta-analysis is to evaluate the effects of preoperative and postoperative ankle pump training on DVT incidence and venous haemodynamic parameters, such as maximum venous outflow (MVO) and maximum venous capacity (MVC). A systematic Literature search was performed across multiple databases up to July 2025 to identify randomized controlled trials (RCTs) that compared ankle pump exercises with standard care in patients undergoing lower limb orthopaedic surgery. Data were pooled using a fixed-effects model. The outcomes included the incidence of DVT (odds ratio (OR)), MVO, and MVC (standardized mean difference (SMD)). Heterogeneity was assessed using the I2 statistic, and the risk of bias was evaluated using the Cochrane Risk of Bias Tool. A total of 16 RCTs involving 1,704 patients (intervention: n = 889; control: n = 815) were included. Compared with routine care, ankle pump exercises significantly reduced the incidence of DVT (OR = 0.27, 95% CI: 0.20–0.37, p < 0.001; I2 = 0.0%, p = 0.523). For MVO, the pooled results from 6 studies revealed a significant improvement in the intervention group (SMD = 0.50, 95% CI: 0.34–0.66, p < 0.001; I2 = 7.8%, p = 0.366). MVC also significantly increased following ankle training (SMD = 0.47, 95% CI: 0.31–0.63, p < 0.001; I2 = 0.0%, p = 0.915). The risk of bias was low to moderate across the included studies. The funnel plots revealed no significant publication bias. This meta-analysis provides Level I evidence that ankle pump exercises significantly reduce the incidence of deep vein thrombosis (DVT) and increase venous haemodynamic parameters—specifically maximum venous outflow (MVO) and maximum venous capacity (MVC)—in patients undergoing lower limb orthopaedic surgery. These findings support the integration of ankle pump exercises into routine postoperative care as an effective, noninvasive strategy to mitigate DVT risk and promote venous return.

The number of thrombotic events in children, although significantly less than that in adults, is increasing as a result of therapeutic advances in primary illnesses that were previously fatal. When a patient, adult or pediatric, develops a deep vein thrombosis and anticoagulation therapy is initiated, many health professionals ask, “When should this patient have physical therapy and/or ambulate?” Fear of causing a pulmonary embolism with increased activity drives this question. Often, an order for bed rest is prescribed based more on tradition than on evidence-based medicine. A review of the literature has provided an evidence-based answer to the question, and although the studies are all of adult populations, the results have been extrapolated for use with comparable pediatric populations. The majority of studies agree that early ambulation does not increase an anticoagulated patient's risk for pulmonary embolism. Moreover, most studies report that early ambulation carries benefits such as decreased pain and swelling and fewer postthrombotic syndrome symptoms.

Background Deep vein thrombosis (DVT) is a significant complication, which often comes along with orthopedic surgery, and leads risks of severe outcomes such as pulmonary embolism. Effective prevention strategies are urgently expected to promote postoperative recovery and reduce complications. Objective This study aims to measure the effectiveness of nursing interventions in preventing postoperative DVT among the patients with orthopedic surgeries, with the focus on outcomes such as DVT incidence, recovery time, and patient satisfaction. This hybrid study integrates a PRISMA-compliant meta-analysis of six independent studies with a prospective clinical case report, bridging population-level evidence and real-world nursing practice. Methods Nursing intervention details (early mobilization and patient education) were firstly collected and assessed in postoperative patients in this research. Key metrics (DVT occurrence, D-dimer level, and patient-reported outcomes) were further analyzed to determine the impact of these interventions. Results Following the nursing interventions, patients demonstrated a lower DVT incidence, the recovery rates as well as patient satisfaction were enhanced, and the symptoms of lower extremity swelling got reduced, despite challenges in adherence to the protocols. Conclusion Nursing interventions play a critical role in DVT prevention in postoperative care for the patients after orthopedic surgeries. These findings support the integration of standardized nursing practices to optimize postoperative outcomes after orthopedic surgeries and highlight the need for addressing adherence barriers to maximize their effectiveness.

BACKGROUND Deep vein thrombosis (DVT) is a significant postoperative concern, particularly in patients undergoing surgery for gastrointestinal (GI) cancers. These patients often present multiple risk factors, including advanced age and elevated body mass index (BMI), which can increase the likelihood of thromboembolic events. Effective prophylaxis is crucial in this high-risk population to minimize complications such as DVT and pulmonary embolism (PE). This study investigates a comprehensive DVT prevention protocol, combining mechanical and pharmacological strategies alongside early mobilization, to evaluate its effectiveness and safety in reducing postoperative thrombosis rates among GI cancer surgery patients. AIM To evaluate the effectiveness and safety of postoperative DVT prevention strategies in patients with GI cancer. METHODS A prospective cohort study was conducted involving 100 patients who underwent surgery for GI tumors between January and December 2022. All patients received a standardized DVT prevention protocol, which included risk assessment, mechanical prophylaxis, pharmacological prophylaxis, and early mobilization. The primary endpoint was the incidence of DVT within 30 days postoperatively. Secondary outcomes included the occurrence of PE, bleeding complications, and adherence to the protocol. RESULTS The overall incidence of DVT was 7% (7/100 patients). One patient (1%) developed PE. The adherence rate to the prevention protocol was 92%. Bleeding complications were observed in 3% of patients. Significant risk factors for DVT development included advanced age [odds ratio (OR): 1.05; 95% confidence interval (95%CI): 1.01-1.09], higher BMI (OR: 1.11; 95%CI: 1.03-1.19), and longer operative time (OR: 1.007; 95%CI: 1.001-1.013). CONCLUSION Implementing a comprehensive DVT prevention and management protocol for patients undergoing GI tumor surgery resulted in a lower incidence. Strict adherence and individualized risk assessment are crucial for optimizing outcomes.

Introduction This study aims to elucidate the risk factors associated with postoperative lower extremity deep vein thrombosis (DVT) in patients afflicted with gynecologic malignancies. Methods A comprehensive search was conducted across CNKI, CQVIP, Wanfang, and PubMed databases for literature published from January 1, 2024, concerning the risk factors for postoperative DVT in patients with gynecologic cancers. Two researchers independently and objectively screened, extracted, and evaluated the pertinent data. Subsequently, the extracted data were subjected to meta-analysis using STATA software. Results A total of twelve studies fulfilling the inclusion criteria were analyzed, encompassing 2,553 cases. The meta-analysis revealed that significant risk factors for postoperative lower extremity DVT in patients with gynecologic malignancies include age [Odds Ratio (OR) = 1.35, 95% Confidence Interval (CI) (1.19, 1.54), P &amp;lt; 0.001], Body Mass Index (BMI) [OR = 1.67, 95% CI (1.05, 2.66), P &amp;lt; 0.001], plasma D-dimer levels [OR = 3.39, 95% CI (1.24, 9.24), P &amp;lt; 0.001], duration of surgery [OR = 2.24, 95% CI (1.24, 4.01), P &amp;lt; 0.001], and duration of postoperative bed rest [OR = 2.14, 95% CI (1.56, 2.94), P &amp;lt; 0.001]. Discussion The study identifies multiple risk factors influencing the incidence of postoperative lower extremity DVT in patients with gynecologic malignancies. Notably, age, BMI, plasma D-dimer levels, surgical duration, and postoperative bed rest emerge as significant predictors. These findings underscore the necessity for targeted prophylaxis and therapeutic interventions in the clinical management of such patients.

Elderly patients face various surgical risks, including complications, slower recovery, prolonged hospital stays, functional decline, and even death. Early ambulation is beneficial in reducing these risks in older adults. However, elderly patients often lack motivation to ambulate due to insufficient understanding and family support, leading to longer bed rest. Aim : To evaluate the impact of early ambulation as an intervention to enhance postoperative recovery in elderly patients. Methods: This is a systematic review study with a PICO approach. Article searches were conducted using online databases such as EBSCO, PubMed, ScienceDirect, SpringerLink, and Scopus with the keywords (Elderly OR Older Adult) AND (Post Operative OR Post Surgery) AND (Early Ambulation OR Early Mobilization) AND (Reduce Length of Stay) published between 2014–2024 and The 5 relevant articles were found. Results: Five studies indicated that the implementation of early ambulation programs in elderly surgical patients not only reduces length of stay but also improves functional capacity and decreases the incidence of complications such as pneumonia, atelectasis, and venous thrombosis. Conclusion: The studies show that early mobilization reduces hospital stays, accelerates organ function recovery, and provides psychological benefits, such as reduced postoperative anxiety.

Background: Prolonged immobility after abdominal surgery increases the risk of postoperative complications and delays recovery. Early ambulation has been proposed as a simple, cost-effective strategy to enhance patient outcomes, yet consistent evidence from randomized controlled trials remains limited. Objective: To evaluate the effectiveness of early postoperative ambulation in improving recovery time and reducing complications following elective abdominal surgery. Methods: This randomized controlled trial was conducted over 12 months at a tertiary care hospital in Lahore, Pakistan. A total of 128 adult patients undergoing elective abdominal surgery were randomly assigned to either an early ambulation group (mobilized within 6 hours postoperatively) or a standard care group. Primary outcomes included time to bowel function return, hospital stay duration, and time to independent ambulation. Secondary outcomes included rates of pulmonary infection, postoperative ileus, deep vein thrombosis (DVT), and pain scores. Data were analyzed using t-tests and chi-square tests, with a significance threshold of p<0.05. Results: Patients in the early ambulation group showed significantly faster recovery: shorter time to first flatus (24.6 ± 6.2 vs. 33.5 ± 7.8 hours), bowel movement (44.1 ± 10.4 vs. 58.3 ± 12.6 hours), and hospital stay (4.8 ± 1.1 vs. 6.3 ± 1.4 days). Complication rates were also lower, particularly for pulmonary infection (4.7% vs. 15.6%) and ileus (6.3% vs. 17.2%). Pain s

The aim of this meta-analysis was to assess if early mobilization and rehabilitation in the intensive care unit (ICU) could reduce ICU-acquired weakness (ICU-AW), improve functional recovery, improve muscle strength, shorten the length of ICU and hospital stays, and reduce the mortality rate. A comprehensive literature search in PubMed, Embase, Web of Science, SinoMed (Chinese BioMedical Literature Service System, China), and National Knowledge Infrastructure, China (CNKI) was performed. Results were expressed as a risk ratio (RR) with 95% confidence intervals (95% CIs) or weight mean difference (WMD) with 95% CIs. Pooled estimates were calculated using a fixed-effects or random-effects model according to the heterogeneity among studies. Fifteen randomized controlled trials involving a total of 1941 patients were included in this meta-analysis. Pooled estimates suggested that early mobilization significantly reduced the incidence of ICU-AW (RR = 0.49, 95% CI: 0.26, 0.91; P = .025), shortened the length of ICU (WMD = -1.82 days, 95% CI: -2.88, -0.76; P = .001) and hospital (WMD = -3.90 days, 95% CI: -5.94, -1.85; P < .001) stays, and improved the Medical Research Council score (WMD = 4.47, 95% CI: 1.43, 7.52; P = .004) and Barthel Index score at hospital discharge (WMD = 21.44, 95% CI: 10.97, 31.91; P < .001). Moreover, early mobilization also decreased complications such as deep vein thrombosis (RR = 0.16, 95% CI: 0.04, 0.59; P = .006), ventilator-associated pneumonia (RR = 0.26, 95% CI: 0.11, 0.63; P = .003), and pressure sores (RR = 0.14, 95% CI: 0.04, 0.44; P = .001). However, early mobilization did not reduce the ICU mortality rate (RR = 1.31, 95% CI: 0.97, 1.76; P = .074), improve the handgrip strength (WMD = 4.03 kg, 95% CI: -0.68, 8.74; P = .094), and shorten the duration of mechanical ventilation (WMD = 0.20 days, 95% CI: -0.10, 0.50; P = .194). This study indicated that early mobilization was effective in preventing the occurrence of ICU-AW, shortening the length of ICU and hospital stay, and improving the functional mobility. However, it had no effect on the ICU mortality rate and ventilator-free days. ICU-AW is a common neuromuscular complication of critical illness, and it is predictive of adverse outcomes. Early mobilization of critically ill patients is a candidate intervention to reduce the incidence and severity of ICU-AW. Some clinical studies have demonstrated this, whereas others found opposite results. The aim of our study is to assess if early mobilization and rehabilitation in the ICU could reduce the ICU-AW, improve functional recovery, improve muscle strength, shorten length of ICU and hospital stay, and reduce the mortality rate.

Background: Early ambulation is a crucial postoperative nursing intervention that significantly reduces complications such as deep vein thrombosis (DVT), pulmonary infections, and prolonged hospital stays. Nurses play a vital role in encouraging and implementing early mobilization to enhance patient recovery. However, their knowledge and practices regarding early ambulation vary, affecting patient outcomes. Objective: This study aimed to assess the knowledge and practices of nurses regarding early ambulation to prevent postoperative complications and identify barriers to its implementation. Methodology: A descriptive cross-sectional study was conducted among 91 nurses working in surgical wards, ICUs, and general wards of a tertiary care hospital. Data were collected using a structured questionnaire assessing demographic characteristics, knowledge, and practice related to early ambulation. The data were analyzed using descriptive and inferential statistics. Results: The findings revealed that 81.3% of nurses correctly identified that early ambulation should begin within 24 hours post-surgery. The majority (70.3%) recognized its benefits in preventing thrombosis, improving gastrointestinal motility, and reducing pulmonary complications. However, only 79.1% consistently encouraged early ambulation, and 46.2% documented patient progress. Barriers to implementation included workload constraints (23.1%), inadequate staffing (27.5%), and patient-related factors (24.2%). Conclusion:

The thickness of the adipose layer is also measured and patient weights are recorded to check for any possible correlations. Clinical measures to reduce the risk of venous thrombosis include: (1) spontaneous breathing without muscle relaxants, (2) no prone positioning in surgery, (4) sequential compression devices, (4) movement of the lower extremities during surgery, and (5) outpatient treatment with early ambulation.2 Patients are cautioned that deep venous thrombosis (blood clots) are a known risk of surgery and that they are to report any asymmetrical swelling of the lower extremities, thigh pain, or fever to their surgeon immediately. Any patient with a positive scan is referred to a local hospital for confirmation and treatment. Null Hypothesis Ultrasound scans are a safe, noninvasive, effective method to detect blood clots in the deep veins of the lower extremities in plastic surgical patients. Informed Consent Patients are informed as to the nature of the study and are told that their participation is entirely voluntary and they are free to decline, and that doing so does not in any way prejudice their treatment. Patient Risk There is no patient risk.

ulcers, deep vein thrombosis (DVT), impaired pulmonary function, and loss of functional mobility. Promotion and execution of early ambulation on patients Knee replacement, also known as knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability. It is most commonly performed for osteoarthritis, but it can also be used for other knee diseases, such as rheumatoid arthritis and psoriatic arthritis. In people with severe deformity from advanced rheumatoid arthritis, trauma, or long Unicompartmental arthroplasty (UKA), also called partial knee replacement, is an option for some people. The knee is generally divided into three "compartments": medial, lateral, and patellofemoral. Most people with arthritis severe enough to consider knee replacement have significant wear in two or more of the above compartments, and are treated with total knee replacement (TKA). A minority of people with osteoarthritis have wear primarily in one compartment, usually the medial, and may be candidates for unicompartmental knee replacement. Advantages of UKA compared to TKA include smaller incision, easier post-op rehabilitation, better postoperative range of motion, shorter hospital… Type 1 (positive intraoperative culture): Two positive intraoperative cultures Type 2 (early postoperative infection): Infection occurring within first month after surgery Type 3 (acute hematogenous infection): Hematogenous seeding of site of previously well-functioning prosthesis Type 4 (late chronic infection): Chronic indolent clinical course; infection present for more than a month While it is relatively rare, periprosthetic infection remains one of the most challenging complications of joint arthroplasty. A detailed clinical history and physical examination remain the most reliable tool to recognize a potential periprosthetic infection. In some cases the classic signs of fever, chills, painful joint, and a draining sinus may be present, and diagnostic studies are simply done to confirm the diagnosis. In reality though, most patients do not present with those clinical signs, and in fact the clinical presentation may overlap with other complications such as aseptic loosening and pain. In those cases diagnostic tests can be useful in confirming or excluding infection. Positive intraoperative cultures: Antibiotic therapy alone Early post-operative infections: debridement, antibiotics, and retention of prosthesis. Acute hematogenous infections: debridement, antibiotic therapy, retention of prosthesis. Late chronic: delayed exchange arthroplasty. Surgical débridement and parenteral antibiotics alone in this group has limited success, and standard of care involves exchange arthroplasty.

Management of postoperative pain: review of current techniques and methods. Pain is a common problem in the early postoperative period. Techniques that provide perioperative analgesia to alleviate pain may have a significant effect on postoperative events, such as earlier ambulation and earlier dismissal from the hospital with use of epidural analgesia than with systemic analgesia. Spinal opioids, which can be administered epidurally or intrathecally, provide analgesia that is superior to that achieved with systemically administered narcotics. For procedures on the upper extremities, selective analgesia can be achieved with use of various types of neural blockade--for example, brachial plexus blockade, interscalene blockade, and axillary plexus blockade. Intercostal nerve block, a valuable but underutilized procedure appropriate for unilateral upper abdominal or flank operations or for thoracotomy, has been shown to reduce postoperative narcotic requirements and pulmonary complications.