Examining the benefit of graduated compression stockings in the prevention of hospital-associated venous thromboembolism in low-risk surgical patients: a multicentre cluster randomised controlled trial (PETS trial).

Introduction: Hospital-acquired thrombosis (HAT) is defined as any venous thromboembolism (VTE)-related event during a hospital admission or occurring up to 90 days post discharge, and is associated with significant morbidity, mortality and healthcare-associated costs. Although surgery is an established risk factor for VTE, operations with a short hospital stay (<48 hours) and that permit early ambulation are associated with a low risk of VTE. Many patients undergoing short-stay surgical procedures and who are at low risk of VTE are treated with graduated compression stockings (GCS).

Traumatic dislocation of the pisiform: a case report.

Isolated pisiform dislocation is rare. We present one such case in a 20-year-old man occurring after a direct injury to the wrist. After an initial delay in diagnosis and unsuccessful closed reduction, he underwent resection of the pisiform.

Venous thromboembolic disease after total hip and knee arthroplasty: current perspectives in a regulated environment.

Venous thromboembolic disease is the single most common reason for readmission to the hospital following total hip and total knee arthroplasty and remains a genuine threat to the life of the patient. Nevertheless, advances in surgical procedure, anesthetic management, and postoperative convalescence have altered the risks of venous thromboembolism after total joint arthroplasty in the lower extremity. Regional anesthetic techniques reduce the prevalence of venographic thrombosis by approximately 50%, and intraoperative monitoring has identified preparation of the femoral canal as the sentinel event that activates the coagulation cascade by the intravasation of marrow fat into the systemic circulation.

A novel approach to mechanical prophylaxis: calf impulse technology mimics natural ambulation more effectively than sequential calf compression.

Background: The risk of thrombosis can be reduced by mechanical compression, but the optimal device is unknown.

Objectives: To record the effect of natural ambulation on deep venous flow, providing a reference for evaluating the efficacy of mechanical compression systems, assuming that ambulation is the gold standard against which such systems should be compared; and to compare the hemodynamic effect of the A-V Impulse System CalfPad garment (A-VI) (Orthofix Vascular Novamedix, United Kingdom) with the SCD Express calf compression garment (SCD) (Covidien, USA).

Methods: Twelve healthy volunteers were recruited and randomly assigned to either A-VI or SCD in a two-device, two-period crossover design.

Venous impulse foot pumps: should graduated compression stockings be used?

It is not known whether the effect of Foot Pumps (Novamedix, Andover, UK) is enhanced by simultaneous use of graduated compression stockings (by controlling calf compliance) or hindered (by restricting preload). To address this question, we studied 20 healthy volunteers with duplex ultrasound. The peak velocity in the popliteal vein was measured at rest with the legs flat, foot-up, and foot-down, then it was measured when the AV Impulse Foot Pump was activated.