Intended for healthcare professionals

Rapid response to:

Clinical Review

Venous thromboembolism

BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7535.215 (Published 26 January 2006) Cite this as: BMJ 2006;332:215

Rapid Response:

Venous thromboembolism and the Importance of Stockings

Editor: It was a delight to read in total nine pages worth of
information on Venous thromboembolism (VTE) in the BMJ over the past two
weeks 1,2. What did strike me amiss is that out of these nine pages only
fifteen words refer to the use of compression stockings and pneumatic
compression devices. I feel that these cheap and completely non-invasive
means of thromboembolic deterrent should have a more marked place.

The evidence behind compression stockings and pneumatic device use is
well known. As long as twenty years ago there was controlled trial
evidence showing the efficacy of graduated compression stockings compared
to 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 VTE in colorectal surgery 4.

Whilst I am sure everyone knows about the use of stockings in
prophylaxis against VTE, I believe it important to give more space to
these devices which are often used as a direct alternative to Heparins
especially when the consequences of bleeding are dire.

1)Robinson GV. Pulmonary embolism in hospital practice. BMJ 2006;
332: 156-160

2)Blann AD, Lip GYH. Venous thromboembolism. BMJ 2006; 332: 215-219

3)Fasting H, Andersen K, Kraemmer Nielsen H et al. Prevention of
postoperative deep venous thrombosis. Low-dose heparin versus graded
pressure stockings. Acta Chir Scand. 1985; 151(3): 245-8

4)Wille-Jorgensen P, Rasmussen MS, Andersen BR et al. Heparins and
mechanical methods for thromboprophylaxis in colorectal surgery. Cochrane
Database Syst Rev. 2003; (4): CD001217

Competing interests:
None declared

Competing interests: No competing interests

29 January 2006
Daniel A. Shaerf
Preregistration House Officer, Orthopaedics and Trauma Surgery
The Royal Free Hospital, Pond Street, London NW3 2QG