Prophylaxis of Perioperative Venous Thrombosis: Role of Venous Compression

Abstract

Aim: To review the role of compression treatments in the prevention of perioperative deep venous thrombosis. Method: A review of current literature in the field of prevention of deep venous thrombosis following general and orthopaedic surgery has been conducted. Synthesis: There is a considerable risk of deep venous thrombosis following surgical treatment in hospital. This is particularly high following joint replacement in the lower limb. This may lead to fatal pulmonary embolism or chronic venous insufficiency of the lower limb with leg ulceration and disability. Perioperative deep venous thrombosis may be prevented by a number of drugs. The most frequently used is heparin or the more modern low-molecular-weight heparins (LMWH). Vitamin K antagonists are also commonly used, but have a long duration of action. Dextrans and aspirin have an effect in preventing perioperative venous thrombosis, but this is much less than heparin. Mechanical methods of prevention have the advantage of preventing venous thrombosis without increased risk of bleeding complications. Conclusion: Heparin and LMWH continue to be the most frequently used means of preventing peri-operative deep venous thrombosis in France. There is reliable to evidence to show that mechanical methods of prevention including graduated elastic compression and intermittent pneumatic compression of the lower limb are also effective. These may be used in combination with heparin for increased protection or as an alternative to anticoagulant drugs where there is a risk of bleeding. They are also effective when used alone.