Aim: The purpose of this study was To know any alteration in plasma
antithrombin III concentration during postoperative period of major orthopedic
Place and duration of study: In hematology section of pathology department at
postgraduate medical institute (PGMI), Lahore
from 1stFebruary2014 to31stJanuary 2015.
Study design: It was an observational
Methods: After visiting orthopedic ward of Services Institute
of Medical Sciences (SIMS) Lahore, forty
patients were selected for this study who were planned and enlisted for major
orthopedic surgery. Out of forty patients, twenty were of male gender and
remaining twenty of female gender, having mean age of 48.6 years. Ten healthy
subjects were selected to constitute control group after a proper matching in
respect to age and sex of subjects in patient group. Two anticoagulated venous
blood samples were drawn from each patient. First sample 24 hours prior to
surgery and second 72 hours after surgery. A single blood sample was drawn from
Results: It was observed at the completion of this study that
almost in all patients there was a remarkable fall in concentration of plasma antithrombin III (AT III) after major orthopedic surgery. This critically
noteworthy fallof29.3% in AT III levels might be the outcome of potent systemic
activation of all clotting factors as a result of local vascular trauma
inflicted during surgical procedure, local vascular stasis, massive trauma to
tissues and release of tissue thromboplastin during surgery.
Conclusion: There was a significant decrease in plasma level of antithrombin III during
postoperative period of major orthopedic surgery, an observation usually not appreciated
in general surgery patients.
Keywords: Preoperative blood sample, Major Orthopedic
surgery, AT III.