Effects of cold application before subcutaneous injection of low-molecular-weight heparin on pain, bruising, and hematoma formation: A randomized controlled trial

Abstract

Aims: With daily subcutaneous low-molecular-weight heparin (LMWH) injections for long periods, there is a high risk of local side effects, such as pain, bruising, and hematoma. This study aimed to compare the impact of cold application on post-injection pain, bruising, and hematoma in patients receiving subcutaneous LMWH following urologic surgery. Methods: This was a single-blind, randomized control trial. Urology inpatients were randomly assigned to three groups; Group 1: cold application for 2 min before injection, Group 2: cold application for 5 min before injection, and Group 3: control group with no cold application. Post-injection pain was assessed immediately after injection. Bruising and hematoma were assessed at 48th and 72nd hours. Results: The study included 26 patients in Group 1 (age=63.85±9.89 years; male=84.6%), 26 patients in Group 2 (age=64.54±11.66 years; male=80.8%), and 26 patients in Group 3 (age=65.65±11.36 years; male=88.5%). The pain scores in Groups 1 (11.58±12.06) and Group 2 (6.08±9.11) were lower than Group 3 (28.35±20.97) (p<0.001). At the 48th hour, the frequency of bruising in Group 1 (11.5%) and Group 2 (11.5%) was lower than that in Group 3 (38.5%) (p=0.021), and the bruise size in Group 1 (4.00±1.73 mm) was lower than that in Group 3 (15.00±7.07 mm) (p=0.020). No hematomas was detected in any patient groups at the 48th and 72nd hours. Conclusions: This study showed that although cold application for 2 or 5 minutes before injection reduced pain and bruising frequency, application for 2 minutes was more effective on bruise size. Copyright © 2024 The Author. Published by Galenos Publishing House on behalf of University of Health Sciences Türkiye, Gülhane Faculty of Medicine. This is an open access article under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 (CC BY-NC-ND) International License.