BMJ  2006;332:364 (11 February), doi:10.1136/bmj.332.7537.364-a

Letter

Venous thromboembolism

Stockings are important

EDITOR—In two recent articles on venous thromboembolism, only 15 words referred to the use of compression stockings and pneumatic compression devices.^{1 2} These cheap and completely non-invasive devices should have a more prominent place.

The evidence behind compression stockings and pneumatic device use is well known. Twenty years ago, controlled trial evidence showed the efficacy of graduated compression stockings with low dose heparin.³ More recently, a meta-analysis showed that graduated compression stockings are a useful adjunct to low molecular weight heparins and reduce the incidence of venous thromboembolism in colorectal surgery.⁴

These devices, which are often used as a direct alternative to heparins, deserve more space, especially when the consequences of bleeding are dire.

Royal Free Hospital, Pond Street, London NW3 2QG shaerf{at}gmail.com

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Competing interests: None declared.

References

1. Robinson GV. Pulmonary embolism in hospital practice. BMJ 2006;332: 156-60. (21 January.)[Free Full Text]
2. Blann AD, Lip GYH. Venous thromboembolism. BMJ 2006;332: 215-9. (28 January.)[Free Full Text]
3. Fasting H, Andersen K, Kraemmer Nielsen H, Husted SE, Koopmann HD, Simonsen O, et al. Prevention of post-operative deep venous thrombosis. Low-dose heparin versus graded pressure stockings. Acta Chir Scand 1985;151: 245-8.[Medline]
4. Wille-Jorgensen P, Rasmussen MS, Andersen BR, Borly L. Heparins and mechanical methods for thromboprophylaxis in colorectal surgery. Cochrane Database Syst Rev 2003;(4): CD001217.

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