Comparison of abdominal and deltoid regions for pain, hematoma and ecchymosis in patients using subcutaneous heparin

ABSTRACT The study was conducted as a semi-experimental comparison of abdominal and deltoid regions for pain, hematoma and ecchymosis in patients using subcutaneous heparin. The study was conducted between June 2013 and July 2014. Its population consisted of all adult patients who were hospitalized in the Orthopedics-Traumatology and Thorax-Cardiovascular Surgery Clinics of Inonu University Turgut Ozal Medical Center to receive subcutaneous heparin therapy. The sample included 54 patients who met the inclusion criteria and who were selected using the non-probability random sampling method. The data collecting tools were a "Patient Description and Follow-Up Form" to record the descriptive and medical characteristics of the patients and information on pain, hematoma and ecchymosis, a "Visual Analoque Scale" to assess pain, the "Opsite-Flexigrid Measurement Grid" to measure hematoma and ecchymosis and a "Stopwatch" to measure the duration of pain. The data were collected using face-to-face interviews held by the investigator, visual examination, palpation and measurement. The injections were done in 24-hour intervals, first into the right arm and second into the right abdominal region. Hematoma and ecchymosis were assessed at 48th hour following each injection, the severity of pain right after the injections and pain duration at the time of injection. The data were analyzed using numbers, percentages, means and standard deviations, Chi-Square test, t-test in dependent groups, Kruskall Wallis Variance test and Mann Withney U test. The study showed that pain developed more in the deltoid region and this was statistically significant. The differences between the abdominal and deltoid regions in terms of mean pain severity and pain duration, and development and size of ecchymosis were not significant. Hematoma developed (in the deltoid region) only in one patient due to heparin injection. Development of more ecchymosis in the deltoid region in patients who used enoxaparin sodium and in female patients was found statistically significant.