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Archivos de Medicina Interna

Print version ISSN 0250-3816On-line version ISSN 1688-423X


BULLA, Daniel. Management of the patient undergoing hip or knee replacement surgery. Arch. Med Int [online]. 2009, vol.31, n.1, pp.32-35. ISSN 0250-3816.

The Internist’s task includes not only the evaluation, assessment and stabilization of patients prior to surgery, but also the management and prevention of complications in the postoperative period. The elderly patient with a hip fracture must be considered a surgical emergency. Although consultations to specialists will be required, it is the role of one of the doctors in the team, the internist, to coordinate the various steps to prevent any unnecessary delays of surgery. Internists must be trained in the management of the main complications that can be seen in this type of surgery, such as deep venous thrombosis and the most feared complication - pulmonary thrombo embolism, the psychiatric disorders such as delusion or acute confusion, as well as nutritional aspects. The internist also has to implement the prevention measures and the treatment of infections both on the surgical site and in other sectors (urinary, skin, pneumonia). Furthermore, the internist must manage the transfusions usually required by these patients, who tend to have high bleeding levels, close to one liter.

Keywords : Internist; Prosthesis; Hip and knee arthroplasty; Prophylaxis of the venous thrombosis; Bleeding; infections; Anesthesia.

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