Calf-thigh sequential pneumatic compression compared with plantar venous pneumatic compression to prevent peen-vein thrombosis after non-lower extremity trauma

Objective: To compare the effectiveness of calf-thigh sequential pneumatic compression devices with the effectiveness of plantar venous intermittent p neumatic compression devices in prevention of venous thrombosis after major trauma. Subjects and Methods: We evaluated 181 consecutive patients after major tra uma without lower extremity injuries that precluded the use of pneumatic co mpression devices. We randomly assigned 149 patients to either calf-thigh s equential pneumatic compression or plantar venous pneumatic compression. Af ter blinding the observers to the method of prophylaxis against deep-vein t hrombosis, we performed bilateral compression ultrasonography on or before day 8 after randomization. Results: Among 149 randomized patients, 62 who received calf-thigh sequenti al pneumatic compression and 62 who received plantar venous intermittent pn eumatic compression de-vices completed the trial. Thirteen patients randomi zed to plantar venous intermittent pneumatic compression (21.0%) and 4 pati ents randomized to calf-thigh sequential pneumatic compression (6.5%) had d eep-vein thrombosis (p = 0.009), Seven of 13 patients with deep-vein thromb osis after prophylaxis with plantar venous intermittent pneumatic compressi on had bilateral deep-vein thromboses, whereas all 4 patients with deep-vei n thrombosis after prophylaxis with calf-thigh sequential pneumatic compres sion had unilateral deep-vein thrombosis. Conclusion: Calf-thigh sequential pneumatic compression prevents deep-vein thrombosis more effectively than plantar venous intermittent pneumatic comp ression after major trauma without lower extremity injuries.