Article

Complications associated with intermittent pneumatic compression

Department of Rehabilitation Medicine, New York Hospital-Cornell Medical Center, NY 10021.
Archives of Physical Medicine and Rehabilitation (Impact Factor: 2.57). 06/1992; 73(5):482-5.
Source: PubMed

ABSTRACT

The intermittent pneumatic compression device (IPCD) is prophylaxis for prevention of deep-venous thrombosis (DVT). This pneumatic leg sleeve has been used extensively in high-risk surgical patients, without complication. We describe two cases, one with peroneal neuropathy and the other with compartment syndrome, associated with IPCD use during surgery. Case 1 involves a patient with pancreatic cancer and weight loss who developed bilateral peroneal nerve palsies during surgery. Case 2 involves a patient with bladder cancer who developed lower leg compartment syndrome during prolonged surgery in the lithotomy position. These cases are unusual for several reasons. First, patients wearing IPCDs during surgery are at increased risk of neurovascular compression. Second, significant weight loss may predispose the peroneal nerve to injury from intermittent compression garments. Third, patients undergoing surgery in the lithotomy position are at risk of compartment syndrome. Therefore, physicians may wish to use another method of DVT prophylaxis in surgical patients with cancer or significant weight loss, or those who are undergoing procedures in the lithotomy position.

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    • "The rarity of these reports suggests that this is either a rare event, or under-appreciated. Four cases of peroneal nerve injury associated with mechanical compression device DVT prophylaxis have also been identified [36-38]. The proposed mechanism of injury is nerve compression against the fibular head. "
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