Elastic Stockings for VTE Prevention – RPTH Journal
RPTH Journal shared a post on LinkedIn about a recent article by Lara N. Roberts and Emma Gee et al, adding:
“Elastic stockings for VTE prevention: is it time to let them go?
Antiembolism stockings (AES) have been a cornerstone of VTE prevention for decades.
But a new editorial by Lara Roberts and Emma Gee in RPTH Journal makes a compelling case that the evidence no longer supports their routine use, and that the time for deimplementation has come.
What the evidence shows:
- The CLOTS1 trial in stroke patients: no meaningful reduction in VTE, but a 5% risk of skin damage (OR 4.2)
- The GAPS trial: adding AES to LMWH was no better than LMWH alone in surgical patients (absolute risk difference 0.3%)
- A meta-analysis confirmed no reduction in DVT, PE, or VTE mortality with AES added to pharmacologic prophylaxis
- Correct application of AES is suboptimal in trials (15–31%) and even worse in the real world (60% incorrect use)
- Skin damage including blisters, ulcers, and necrosis occurs in 3–5% of patients
Beyond clinical harm:
- AES use costs an estimated £63 million annually in England for surgical patients alone, including nursing time, procurement, and supply chain
- Made from non-recyclable synthetic materials, AES contribute to healthcare’s environmental footprint
With earlier mobilisation and shorter hospital stays now standard, the clinical context in which AES were originally shown to work has largely disappeared.
The authors call for a planned, systems-level deimplementation strategy, supported by staff education, updated guidelines, and post-implementation surveillance.
A bold but evidence-based position worth reading.”
Title: Elastic stockings for venous thromboembolism prevention, time to go
Authors: Lara N. Roberts, Emma Gee
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