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In this case, mechanical prophylaxis is indicated.
In minor orthopaedic surgery, passive mechanical prophylaxis is often the only advisable prophylaxis in low-risk patients [1, 3].
Mechanical prophylaxis is based on the use of graduated compression stockings (GCS) and on intermittent pneumatic compression (IPC) devices [17].
Mechanical prophylaxis is based on the use of elastic compression stockings (passive mechanical prophylaxis) and intermittent pneumatic pumps (active mechanical prophylaxis) [1, 3].
At present, pharmacological and/or mechanical prophylaxis is started in all cases of major orthopedic surgery (MOS), including elective HR and KR, and FNF surgery, as well as in several other cases of fracture (high-impact trauma, multiple fractures, multiple trauma) [1].
Mechanical prophylaxis is suggested when risks for bleeding and thrombosis are elevated.
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Elective indications for mechanical prophylaxis are high risk of thrombosis accompanied by contraindications to pharmacological prophylaxis.
Mechanical prophylaxis was defined by order only.
A low rate of VTE was also found in a recent study when mechanical prophylaxis was used [ 28].
Mechanical prophylaxis was only protocolized for use if anticoagulant prophylaxis was contraindicated (major bleeding, high risk for major bleeding, or suspected or proven heparin-associated thrombocytopenia).
Thus, if mechanical prophylaxis was not routinely applied to patients, or if subsequent doses of pharmacologic prophylaxis were routinely missed or not administered, then we wouldn't expect to see an impact of the intervention on VTE rates.
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