I practiced in centers in which “mini-heparin” was considered as the gold standard for DVT prophylaxis. Peri-operative heparin prophylaxis was used by us selectively according to well known protocols. My personal experience is not recorded- but for many years -working in large University hospitals ,I do not recall encountering any case of clinically significant postoperative pulmonary embolism.
DVT prophylaxis in USA
In this country, however, everybody around me uses Venodyne-pneumatic compression device for DVT prophylaxis. Over a period of 2 years we presented, however, in our M & M at least 4 patients with clinically significant PE in patients in whom this devise was used.
To my comments that mini-heparin is a more effective prophylactic method I am told that the pneumatic devise is as good. I am also told that the pneumatic devise is as effective when applied to the arm-generating systemic anti-thrombotic effects.
Now, I have seen studies which compare pneumatic devise to NO prophylaxis; but I am not aware about any study prospectively comparing heparin prophylaxis to the pneumatic compression devise in high risk patients.
What is your DVT prophylaxis method of choice? Why?