Learning Objective #1: Name the three parts of Virchow's triad that are the accepted pathophysiology causing deep vein thrombosis

Learning Objective #2: List two advantages of using knee-high compression compared to thigh-high compression

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Deep vein thrombosis and pulmonary embolism are serious complications of the surgical patient. Virchow's triad of venous stasis, venous injury, and hypercoagulability is a widely accepted pathophysiology causing DVT. Leg compression is a safe, established method of prophylaxis because it increases blood velocity in the immobilized patient, however, there is a lack of consistency in the doctors' orders and unclear guidelines of policy to direct our practice for the many methods of compression available. Our objective was to search the literature for the best method of mechanical leg compression to prevent DVT. Graduated compression or elastic stockings work by applying a pressure gradient on the legs to enhance venous return and increase venous blood flow velocity. As few as one patient in five have a proper fit which is essential to this method and there is a danger of patient injury if the elastic is too tight causing a tourniquet effect. ES should be used on the low risk patient in conjunction with early ambulation. Pneumatic compression has a "fibrinolytic effect" making them a superior method of compression for the moderate to high risk patient. The knee high versions of both methods of compression are equal in preventing DVT compared to the thigh high compression. The knee high method is cheaper, easier to apply and more comfortable. It is the preferred method for patients and nurses thus increasing compliance which is so key to mechanical compression. Nurses should stratify patients level of risk for DVT as low, medium or high risk and use the appropriate mechanical compression. Nurses should uses the knee high method of compression as it is equal to the thigh high compression to prevent DVT in the surgical patient.