Using different lengths of anti-embolic stockings to prevent deep vein thrombosis in post-operative patients

Abstract

Deep vein thrombosis is a serious complication following major surgical interventions and there is an ever growing interest for research and discussion regarding the prophylaxis of such a complication. Graduated compression elastic stockings are non-invasive, non-pharmacological and an effective form of reducing the incidence of deep vein thrombosis in conjunction with pharmacological prophylaxis. Despite their efficiency there is still debate over the preferred choice of length; knee-length or thigh-length. Therefore, the following research question was formulated: ‘How do knee length graduated compression stockings and thigh length graduated compression stockings compare in reducing the incidence of deep vein thrombosis in post abdominal surgery patients?’ Included in this disseratation were English language publications from 2002 onwards involving adult patients undergoing major abdominal surgery, and considered the comparison between knee-length and thigh-length graduated compression stockings for reducing the incidence of deep vein thrombosis as the main outcome. The search was performed using the combination of 19 keywords in five databases, resulting in 380 hits. 21 were found to be highly relevant and following the use of the CASP and PRISMA tools, five studies were selected (two meta-analyses, two systematic reviews and one randomised control trial). Current literature found that an insignificant statistical difference has been found between the effectiveness of both lengths of stockings. However, taking into consideration patient compliance, ease of application and cost-effectiveness, the use of knee-length stockings was recommended. Future research and data collection regarding the local situation is still highly recommended to establish this difference, further enhance prophylactic care and allow the formulation of policies and protocol in relation to the use of the stockings. Training sessions and informative seminars should allow the multidisciplinary team to remain abreast with developments regarding this issue, in addition to raising awareness of the importance of the prevention of deep vein thrombosis in postoperative patients.