Table 4.

Suggested guidelines for prevention of VTE in routine isolated foot and ankle surgery (with/without immobilization and reduced weight bearing)

Start mechanical VTE prophylaxis at admission using one of the following:

Anti-embolic stockings (thigh or knee length)—assuming no contraindications

Foot impulse devices

Intermittent pneumatic compression devices (thigh or knee length)

If patient has a history or previous VTE/thrombophilia or two or more risk factors below consider chemical prophylaxis (LMWH commencing 6–12 h after surgery until discharge from hospital or if immobilized and/or reduced weight bearing continue until the patient no longer has significantly reduced mobility)

Active cancer or cancer treatment

Age over 60 years

Smoking

Critical care admission

Dehydration

Obesity [body mass index (BMI) over 30 kg/m2]

Use of hormone replacement therapy

Use of oestrogen-containing contraceptive therapy

Varicose veins with phlebitis