Mechanical Prophylaxis for Post-Traumatic VTE: Stockings and Pumps

Trauma patients pose unique challenges when it comes to the decision for optimal thromboprophylaxis. Risk reduction of venous thromboembolic (VTE) events is paramount in the modern management of trauma patients. The choice of pharmacologic prophylaxis is standard for most hospitalized patients. However, the potential for bleeding complications with this therapy, in a subset of major trauma patients, can have dire consequences. Fortunately today, a variety of mechanical compression methods exist to assist in the optimal management of VTE prophylaxis for trauma patients. Graduated compression stockings, pneumatic compression devices, foot pumps, and neuromuscular electrical stimulators are just a few of the choices in today’s providers’ armamentarium. In this review, we discuss the need for mechanical VTE prophylaxis in trauma patients, the mechanisms of clot prevention associated with the available devices, and take an evidence-based look at the efficacy of the mechanical methods available for VTE prophylaxis.