THE EFFICACY OF TOPICAL HEPARIN PREPARATIONS FOR THE MANAGEMENT OF PAIN AND SUPERFICIAL VASCULAR DISORDERS IN ORTHOPAEDIC SURGERY AND MUSCULOSKELETAL TRAUMA
CĂLIN TUDOR HOZAN 1,2*, GHEORGHE FARAGO 1, CĂLIN ADRIAN MAGHERU 1,2, BOGDAN UIVARĂȘEANU 1,2, PATRICIA LAURA BELEIU 1
1Orthopedics and Traumatology Department, Emergency Clinical Hospital Oradea, Romania 2University of Medicine and Pharmacy, Oradea, Romania
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Superficial symptoms (oedema, inflammation, hematoma) following musculoskeletal trauma or orthopaedic interventions are more difficult to resolve when the prescription includes heparin and nonsteroidal anti-inflammatory drugs only for systemic administration. That is why treatment prescription often includes also preparations with heparin for topical administration, available on the market in various concentrations and combinations. The present study aimed to evaluate comparatively and in clinical conditions the efficacy and safety of three topical preparations with heparin: a gel with heparin 1000 IU/g, a gel with heparin 500 IU/g and penetration enhancers (dexpanthenol and allantoin) and a gel with 500 IU/g heparin in combination with diclofenac 10 mg/g and a penetration enhancer (dexpanthenol). The study group consisted of 199 patients treated in the Orthopaedics and Traumatology department for musculoskeletal injuries or with orthopaedic surgeries assigned in 3 groups corresponding to each topical preparation studied. At inclusion and then after 3, 7 and 14 days of treatment, the following parameters were evaluated: spontaneous pain, pain on active movement, pain on passive movement (using a VAS scale 0 - 10), hematoma area (cm2) and inflamed area (cm2). The results show that the heparin gel 500 IU/g in combination with diclofenac 10 mg/g and a penetration enhancer (dexpanthenol) was the most effective in relieving the investigated symptoms, since it reported the largest differences in improvement from baseline even after 7 days of treatment. The highest difference from baseline was obtained for hematoma area and for inflamed area. All three topical preparations were well tolerated. The conclusion of the study is that topical administration of the combination of heparin and diclofenac together with penetration enhancers controls better and faster post-traumatic or post-surgical superficial symptoms, and the addition of this type of preparation in the post-traumatic treatment regimen brings a definite benefit for patient
