Thrombophlebitis
Ted stockings
- Check arterial circulation not compromised
- ABPI if in doubt
- ABPI < 0.5: art dis likely, no Teds
- ABPI 0.5 - 0.8 balance risk
- ABPI > 0.8 Teds generally okay
- There is no good evidence to guide choice of treatments
- Treat pain with an oral NSAIDs (or paracetamol)
- NSAIDs - beware asthma, GI Bleed, Renal Fxn etc
- No evidence to support topical NSAIDS
- Advise local heat but keep mobile
- Consider Ted stocking while mobile, elevate limb when resting
- Anticoagulation (or antiplatelets) not necessary
- Thrombophlebitis primarily = inflammation + fibrin clot
- Antibiotics rarely - (fluclox or clarithromycin) only if ? septic (skin break e.g IVDU)
- IVDU often have unusual infections (botulism, MRSA, Group A strep)
- Admit suppurative thrombophlebitis, systemically unwell, DVT, suspect PE (chest pain/SOB etc)
- Consider a thrombophilia screen if thrombophlebitis in a previously normal superficial vein with no obvious trigger
- Beware migratory or recurrent thrombophlebitis (underlying malignancy, vascular lesion or inflammation e.g. Behçet's synd)
