Understanding the problem

For decades, in some hospitals, people undergoing surgery have been told they should wear graduated compression stockings as long as they are in hospital and sometimes even after they are discharged home. Surgery increases inflammation and immobility which increases the risk of DVT and PE. The standard compression stockings used in hospitals apply gentle pressure to the leg veins to increase blood flow with the goal of reducing the risk of DVT and PE.

When compression stockings were first used after surgery decades ago, blood thinners were not typically used, and compression stockings were the only method available to prevent DVT. However, practice has changed and now blood thinners, given by injection or taken by mouth, are commonly used after surgery. Despite the shift in practice, patients are still routinely given compression stockings in addition to blood thinners after surgery at some hospitals.

Unlike blood thinners, compression stockings do not increase the risk of bleeding after surgery. However, they have their own set of complications. Some people who wear compression stockings experience skin breakdown with ulcers, abrasions, and rashes. They can be hot and uncomfortable which makes it difficult for some people to tolerate them. Lastly, compression stockings are associated with a significant cost, especially when you consider the number of surgeries that are performed every day.

The researchers wanted to know if there was any benefit from adding compression stockings to blood thinners in people who have surgery that requires a hospital stay. In other words, are blood thinners plus compression stockings better than blood thinners alone at preventing DVT after surgery?