Elliott CG, Dudney TM, Egger M, Orme JF, Clemmer TP, Horn SD,
Weaver L, Handrahan D, Thomas F, Merrell S, Kitterman N, Yeates S.
Calf-thigh sequential pneumatic compression compared with plantar venous
pneumatic compression to prevent deep-vein thrombosis after non-lower extremity
trauma.
J Trauma 1999 Jul;47(1):25-32

Department of Medicine, LDS Hospital and the University of Utah School of
Medicine, Salt Lake City 84143, USA. ldgellio@ihc.com

OBJECTIVE: To compare the effectiveness of calf-thigh sequential pneumatic
compression devices with the effectiveness of plantar venous intermittent
pneumatic compression devices in prevention of venous thrombosis after major
trauma. SUBJECTS AND METHODS: We evaluated 181 consecutive patients after major
trauma without lower extremity injuries that precluded the use of pneumatic
compression devices. We randomly assigned 149 patients to either calf-thigh
sequential pneumatic compression or plantar venous pneumatic compression. After
blinding the observers to the method of prophylaxis against deep-vein thrombosis,
we performed bilateral compression ultrasonography on or before day 8 after
randomization. RESULTS: Among 149 randomized patients, 62 who received calf-thigh
sequential pneumatic compression and 62 who received plantar venous intermittent
pneumatic compression devices completed the trial. Thirteen patients randomized
to plantar venous intermittent pneumatic compression (21.0%) and 4 patients
randomized to calf-thigh sequential pneumatic compression (6.5%) had deep-vein
thrombosis (p = 0.009). Seven of 13 patients with deep-vein thrombosis after
prophylaxis with plantar venous intermittent pneumatic compression had bilateral
deep-vein thromboses, whereas all 4 patients with deep-vein thrombosis after
prophylaxis with calf-thigh sequential pneumatic compression had unilateral
deep-vein thrombosis. CONCLUSION: Calf-thigh sequential pneumatic compression
prevents deep-vein thrombosis more effectively than plantar venous intermittent
pneumatic compression after major trauma without lower extremity injuries.