Fifty-five patients received three subcutaneous heparin injections (165 injections) by the same investigator using additional techniques such as mechano-analgesia and cold application, and without any additional techniques.

The abdomen was divided into four quarters. The first, second, and third SC heparin injections were applied from the right abdominal region using ShotBlocker®, left abdominal region with an ice pack, and lower abdominal region without any additional application, respectively. All the injection sites were circled using a skin marking pen (r = 5 cm).

All the injections were administered following a standard procedure. Pain and satisfaction were assessed immediately after the injection by using the VAS score. Ecchymosis was assessed with an ecchymosis measurement tool at 48 and 60 hours after the injection (Figure 3).

Inclusion Criteria:

• Must be older than 18 years
• Open to communication
• No complications during the operation
• Normal body mass index (BMI; reference range, 18.5-29.9 kg/m2) (d) and
• Platelet count (150.000-300.000)
• Give consent to participate in the study

Exclusion Criteria:

• Oral and parenteral anticoagulant treatment for at least 5 days
• Infection, scar tissue or incision, and parenteral treatment in their abdominal area
• Hematological and allergic disease

This study was conducted on receiving treatment patients in the Orthopedics and Traumatology wards of a university hospital.