Abstract
Background
Venous thromboembolism deterrent (TED) stockings are recommended for all orthopaedic patients. Clinical evidence supporting their use is limited and the risk of DVT increases four-fold if pressure gradients are reversed. This study aims to investigate the efficacy of TED stockings and their application using pressure gradients as the outcome measure.
Methods
We audited TED stockings over two discrete periods. In the first, cases were assessed for sizing, cutting in and tolerance. In the second we added pressure measurements along the saphenous vein; before and 2 and 3 days after surgery. Between the 2 series, a more rigorous sizing and re-sizing protocol was implemented.
Results
In the first period, 80% of TED stockings were incorrectly sized, 48% cut in and compliance was 60%. In the second period, 34% of stockings were incorrectly sized, 20% cut in and compliance was 93%. Reverse gradients were observed in 21% of patients.
Conclusion
Previous studies had shown reverse gradients in 54% of cases however we found significantly fewer (P=0.000). We attribute this to better fitting rather than quality of the stockings. The effectiveness of graduated compression stockings is more practice than device dependent.
