What are the primary strategies for DVT prophylaxis in surgical patients?

• A. Mechanical methods alone
• B. Pharmacologic prophylaxis alone
• C. Mechanical methods, plus pharmacologic prophylaxis when not contraindicated
• D. No prophylaxis is necessary

Answer: (C)

Preventing deep vein thrombosis after surgery relies on addressing both venous stasis and clotting tendency, so the best approach uses both mechanical methods and pharmacologic protection whenever it is safe to do so. Mechanical methods, such as sequential compression devices or graduated compression stockings, improve blood flow in the legs and reduce venous pooling during and after surgery. Pharmacologic prophylaxis uses anticoagulants to lower the blood’s ability to form clots. When a patient has no contraindications to anticoagulation (for example, no active bleeding and acceptable bleeding risk), using both strategies together provides the strongest protection against DVT and its potential complication, pulmonary embolism. If there is a significant bleeding risk or another contraindication, pharmacologic protection may be withheld, and mechanical methods alone are used. Opting for no prophylaxis is not appropriate because surgical patients have a substantial risk of DVT without prevention.