Physical prophylaxis for thromboembolism. Current state of knowledge on use of medical thromboprophylaxis stockings

BACKGROUND: Thromboprophylaxis in surgery patients is a combination of physical and medical thromboprophylaxis. The established mode of physical thromboprophylaxis in Germany is graduated compression stockings. Recent publications from various authors generally scrutinized the additional benefits of physical prophylaxis in patients who received medical thromboprophylaxis. MATERIAL AND METHODS: A thorough search was carried out in PubMed and Medline. The focus of the search was on studies which investigated the advantages of physical thromboprophylaxis in surgery patients. RESULTS: The low amount of evidence available for prophylaxis of thromboembolism in surgery patients was mainly deduced from trials that had a combination of medical and physical thromboprophylaxis as part of the study protocol. The results of experimental investigations were able to show a statistically highly significant reduction of the diameter of lower extremity veins. CONCLUSION: There is no current evidence to support refraining from routine use of graduated compression stockings in surgery patients. This is also the case for the new oral anti-Xa and anti-IIa inhibitors.