Sequential Compression Device Compliance in Postoperative Obstetrics and Gynecology Patients

Abstract

III.

Adherence to mechanical thromboprophylaxis after surgery: A systematic review and meta-analysis

“…The only study with elastic stockings reported adherence of 40%. In half of the studies (n = 4), patients were asked why they were not adherent to prophylaxis [8,11,12,14]. Commonly reported reasons included sleep disturbance, discomfort, the device not being replaced or turned on by nurses, or the device being too hot or noisy.…”

“…The studies varied in their definitions of adherence, frequency of assessment, length of follow-up and completeness of reporting (Table). In 6 studies, investigators assessed adherence by periodic scheduled visits to the patients in which observers would note whether the patients were correctly using the devices [7,8,10,[12][13][14]. In 2 studies, adherence was measured using a built-in meter that recorded the amount of time the device was in use [9,11].…”

“…Another issue is how studies defined patients who were not wearing the device while performing an activity such as bathing or walking. Some authors counted this as adherent [12][13][14]; some as a non-observation [7]; others authors did not specify how they handled this situation [8][9][10][11].…”

Prevention of venous thromboembolism in gynecologic oncology surgery

“…Real world challenges to this include the availability of the equipment and patient adherence. A study of obstetrics and gynecology patients noted that only 58% of patients were using the pneumatic compression devices as indicated, highlighting the difficulty of using pneumatic compression devices alone in the real world setting [26]. …”

Risk Stratification and Prophylaxis of Venous Thromboembolic Events in Obstetrics

“…It may now be worthwhile to invest in those logical strategies that can lead to the most optimal results. With regard to the risks and benefits of VTE prophylaxis, one may need to consider the possible bleeding consequences of pharmacologic prophylaxis, [5][6][7][8] as well as the sometimes limited effectiveness or compliance of using the mechanical modality of Sequential Compression Devices (SCDs) [9]. The potential impact of any standardized use of a VTE prophylaxis measure in obstetric/gynecologic practice needs to be considered [10][11][12].…”