Thromboprophylaxis in trauma: a review of methods, evidence and guidelines

Venous thromboembolism is a common cause of morbidity and mortality in trauma patients. Mechanical and pharmacological methods of thromboprophylaxis are available and guidelines relating to thromboprophylaxis in trauma include those published by the American College of Chest Physicians, the UK-based National Institute of Clinical Excellence, the Scottish Intercollegiate Guidelines Network and US-based Eastern Association for the Surgery of Trauma. All four guidelines have in common a recommendation for the use of low-molecular-weight heparin except where contraindicated. However, there is little consensus between guidelines relating to which mechanical methods should be used. Given the risk of thromboembolism in trauma patients and increasing interest in this condition clinicians should be aware of local and national guidelines relating to venous thromboembolism prevention in trauma patients. This paper reviews methods of thromboprophylaxis and compares guidelines relating to their use in trauma patients.