American College of Foot and Ankle Surgeons' Clinical Consensus Statement: Risk, Prevention, and Diagnosis of Venous Thromboembolism Disease in Foot and Ankle Surgery and Injuries Requiring Immobilization

Thepurposeofthisdocumentistoprovideguidanceforphysiciansregardingtherisk,prevention,anddiagnosisof venous thromboembolism disease after foot and ankle surgery and while caring for lower extremity injuries that require ankle immobilization. A panel composed of all authors of this document reviewed the published evidence and,throughaseriesofmeetings,reachedconsensusregardingtheviewpointscontainedherein.Weconcludethat routine chemical prophylaxis is not warranted; rather, patients should be stratified and have a prevention plan tailored to their individual risk level. An effective venous thromboembolism prevention program is typically multimodal and focuses on addressing any modifiable risk factors, use of mechanical prophylaxis, early mobilization,andcarefulconsiderationoftheuseofchemicalprophylaxis.The finaldecisionregardinguseandmethod(s) of prophylaxis adopted should be agreed upon by both the clinician and patient after a discussion of the potential benefits and harms as they relate to the individual. This should take place preferably during the preoperative visit orintheimmediatepost-injurysetting,anditmayneedtoberevisitedduringthecourseofcareifthepatient’srisk