Perioperative thromboprophylaxis has been studied over the past 35 years and effective prophylactic methods have been developed, thus lowering the incidence of venous thromboembolic complications after surgery. Implementing the results from clinical trials to daily clinical practice can although be difficult.

Objectives: To summarize and evaluate the progress in the current practice of thromboprophylaxis (TP) in Danish surgical departments over a 20 year period.

Methods: Summary of 5 questionnaires in 1981, 1985, 1990, 1995 and 2000. The questionnaires were designed in the same way through the years.

Results: Replies was obtained from 85%-95% of the Danish surgical departments. The overall use of TP increased from 90% to 100% during twenty years. The use of TP according to a written guideline increased significantly from 50% to 93% (p < 0,001). Low molecular weight heparin was the drug of choice in 98% of the departments in the year 2000 and graded compression stockings in 79%. TP in emergency surgery increased from 33% to 43%. Extended prophylaxis has not gained impact in Denmark as only 17% of the orthopaedic surgery departments used TP for more than 14 days. The use of acetylsalicylic (ASA) acid as postoperative venous thromboprophylaxis has stopped, only 0,5% used ASA in 2000 as compared to 13% in 1990.

Conclusion: The development in attitudes towards TP in Denmark complies with the scientific evolution. Methods and indications correspond with the recommendations of the literature and international consensus conference. However, the low rate of TP in emergency surgery is unsatisfactory. The authors emphasize the introduction of firm standard instructions for TP in all surgical departments. A continuous evaluation of the use of TP in Danish surgical departments by means and quality assurance studies is recommended.