Why the risk rises postoperatively
A venous thromboembolism (VTE) — that is, a deep vein thrombosis and, as a consequence, possibly a pulmonary embolism — is among the relevant complications after operations. The cause lies in the interplay of several factors: patients are less mobile after the procedure, venous return from the legs slows down, and the tendency to clot is altered by the operation. This combination has long been described as the so-called Virchow triad of stasis, hypercoagulability and endothelial injury.
How high the risk is in an individual case depends on the type and duration of the procedure, mobility and individual risk factors. This is precisely why hospitals work with a risk stratification: it assigns each patient a risk profile and derives the appropriate prophylaxis from it.
The measures at a glance
Basic measures
Early mobilisation and movement exercises are the basis of any thromboprophylaxis and are aimed for in almost all patients.
Pharmacological prophylaxis
Anticoagulant medicines (e.g. low-molecular-weight heparins) reduce VTE risk. In many situations they are the means of choice, but they are not an option for everyone — for example in the case of an increased bleeding risk.
Mechanical prophylaxis
The physical methods include medical thromboprophylaxis stockings (MTPS) and intermittent pneumatic compression (IPC). IPC promotes venous return through cyclic compression without intervening in blood coagulation.
Where IPC has its place postoperatively
Mechanical prophylaxis by means of IPC is particularly relevant when pharmacological prophylaxis is contraindicated — for example in the immediate postoperative phase with a bleeding risk. In the high-risk setting, for instance in orthopaedic joint replacement, it is often combined with pharmacological prophylaxis after risk assessment. The classification follows the S3 guideline on VTE prophylaxis (AWMF 003-001); the specific indication is always determined by the treating professionals.
What matters in the ward routine
For prophylaxis to work, it has to be available and applicable correctly — precisely when it is indicated. A mobile IPC device such as the Phlebo Press® DVT 650 Easy with automatic pressure control and care-friendly operation can be integrated into the postoperative routine without complicating it. In the end, the actual goal remains: fewer VTE complications and more patient safety.
Frequently asked questions
Why is the risk of thrombosis increased after an operation?
After operations, several risk factors come together: reduced mobility, surgery-related changes in coagulation and possible irritation of the vessel wall. These factors favour the formation of blood clots in the deep leg veins.
Which thromboprophylaxis measures are available after an operation?
In principle, a distinction is made between basic measures (early mobilisation, movement exercises), pharmacological prophylaxis and mechanical methods (medical thromboprophylaxis stockings and intermittent pneumatic compression, IPC) — used individually or in combination depending on the risk profile.
When is IPC used postoperatively?
Intermittent pneumatic compression is particularly relevant when pharmacological prophylaxis is not an option — or as an addition in high-risk settings. The indication is determined by the treating professionals.