Deep vein thrombosis in major trauma

Major trauma patients are at increased risk of developing deep vein thrombosis (DVT). Certain injuries may be associated with an increased DVT risk, though definitive evidence regarding specific risk factors is lacking. The role of mechanical thromboprophylaxis in major trauma remains unclear and these methods are often contraindicated in lower limb injuries. Low molecular weight heparin is effective in reducing DVT frequency in major trauma with acceptable haemorrhagic complications. Evidence regarding the efficacy of thromboprophylaxis specifically in major trauma patients is lacking. However, recently published guidelines from the National Institute for Health and Clinical Excellence appear to make recommendations based on findings in other patient populations rather than using the best available evidence in major trauma patients. Future studies must identify specific DVT risk factors in major trauma to allow accurate risk stratification, determine the time period patients remain at increased DVT risk and establish the role of combined thromboprophylaxis.