A COMPARISON OF INTERMITTENT PNEUMATIC COMPRESSION OF THE CALF AND WHOLE LEG IN PREVENTING DEEP VENOUS THROMBOSIS IN UROLOGICAL SURGERY

Purpose: Intermittent pneumatic compression of the calf and/or thigh e ffectively decreases the incidence of deep venous thrombosis and other thrombotic sequelae but clinical data comparing these modalities are Currently lacking. Materials and Methods: A total of 90 patients under going major urological surgery was randomly assigned to receive calf l ength or thigh length pneumatic compression for antithrombotic prophyl axis. Duplex ultrasound of the lower extremities was performed preoper atively and twice postoperatively to evaluate for deep venous thrombos is. Health care providers in the operating room, recovery room and war d were asked to compare the compression systems, and a cost analysis w as performed. Results: A total of 47 patients wore the thigh length se quential pneumatic sleeves and 43 wore calf length uniform compression systems. A pulmonary embolus without evidence of deep venous thrombos is was detected in 1 patient (2%) using the thigh length system. A thr ombus was detected in the common femoral vein by duplex ultrasonograph y in 1 patient (2%) with the calf length system. Nursing personnel fou nd the calf length sleeves easier to apply and more comfortable by pat ient account but they were satisfied with both systems. There was a si gnificant cost savings with the calf length pneumatic compression syst em. Conclusions: Calf and thigh length pneumatic compression systems s imilarly decrease the risk of deep venous thrombosis in patients under going urological surgery. The calf length system has the added advanta ge of being less expensive and easier to use.