What is the general practice for appying graduated compression stockings pre-operatively on a patient with a fractured hip, femur, or tibia? Some of our surgeons just have a blanket order to apply GCS (TED hose) no matter when the patient may go to surgery. If a patient is not medically stable for surgery, he or she may be bed-bound for a few days. How does one do a thorough skin assessment with stockings and possibly in traction as well. We have had two cases in the past year of DTI related to just this problem. Nurses are reluctant to remove stockings prior to surgery due to pain. Even with pre-medicating, it is painful to the patient to remove and replace such stockings. I am looking at all suggestions.

We stopped using TED hose last year and now use bilat foot SCD's. Research articles have shown that these are highly effective if used properly (as in patient/staff compliance). After using these on several hundred patients, we have only had 2 instances of DVT...a pretty good percentage! They are so much more comfortable, and it is much easier to assess the skin...also have fewer skin issues without the TEDS!!