Morris RJ, Woodcock JP.
Evidence-based compression: prevention of stasis and deep vein thrombosis.
Ann Surg. 2004 Feb;239(2):162-71.
PMID: 14745323 [PubMed - in process]

Department of Medical Physics and Bioengineering, University of
Wales College of Medicine, Cardiff, Wales. morrisrj@cf.ac.uk
OBJECTIVE: To summarize the currently published scientific
evidence for the venous flow effects of mechanical devices,
particularly intermittent pneumatic compression, and the relation
to prevention of deep vein thrombosis (DVT). SUMMARY
BACKGROUND DATA: While intermittent pneumatic compression is an established method of DVT prophylaxis, the variety
of systems that are available can use very different compression
techniques and sequences. In order for appropriate choices to be
made to provide the optimum protection for patients, the general
performance of systems, and physiological effects of particular
properties, must be analyzed objectively. METHODS: Medline
was searched from 1970 to 2002, and all relevant papers were
searched for further appropriate references. Papers were selected
for inclusion when they addressed specifically the questions posed
in this review. RESULTS: All the major types of intermittent
compression systems are successful in emptying deep veins of the
lower limb and preventing stasis in a variety of subject groups.
Compression stockings appear to function more by preventing
distension of veins. Rapid inflation, high pressures, and graded
sequential intermittent compression systems will have particular
augmentation profiles, but there is no evidence that such features
improve the prophylactic ability of the system. CONCLUSIONS:
The most important factors in selecting a mechanical prophylactic
system, particularly during and after surgery, are patient
compliance and the appropriateness of the site of compression.
There is no evidence that the peak venous velocity produced by a
system is a valid measure of medical performance.