Randomised clinical trial to assess the feasibility for a larger study comparing the use of three Veno-Thrombo-Embolic prophylaxis treatments in patients undergoing major abdominal surgery.

Prior to surgery the patient will be randomised to either the intervention or control group. When in the operating theatre the intervention group will have compressions stockings plus low molecular weight heparin plus intermittent pneumatic compression devices placed on their legs and device commenced. The control group will have only have the compression stockings and standard dose of Low molecular weight heparin. After surgery both groups will follow standard treatment. IPCDs are a therapeutic technique used in medical devices that include an air pump and inflatable auxiliary sleeves in a system designed to improve venous circulation in the limbs of patients who suffer edema or the risk of deep vein thrombosis (DVT) or pulmonary embolism (PE). The intervention group will have the intermittent pneumatic devices still on legs and only taken off for walking and showering. The standard dose of low molecular weight heparin (LMWH) is 40mg by subcutaneous injection once a day for the length of hospital stay. IPCDs are a therapeutic technique used in medical devices that include an air pump and inflatable auxiliary sleeves in a system designed to improve venous circulation in the limbs of patients who suffer edema or the risk of deep vein thrombosis (DVT) or pulmonary embolism (PE). Compression stockings are elastic garments worn around the leg, compressing the limb. This reduces the diameter of distended veins and increases venous blood flow velocity and valve effectiveness. Knee-high compression stockings are used not only to help increase circulation, but also to help prevent the formation of blood clots in the lower legs. The GCS in both groups are to be worn at all times except when showering or if soiled. The IPCDs are to be removed if walking, showering or soiled and in this case need to be replaced. The group wearing the IPCDs will not have to them after discharge. Both groups will be advised to continue wearing the GCS for four weeks post discharge. Prior to discharge both groups will have follow-up bilateral ultrasounds of lower legs at a vascular lab at day 30. A letter to the GP will be sent to explain the patient is in this study if they present with signs of a deep vein thrombosis or pulmonary embolism. One week prior to the ultrasound a research team member will ring the patient to remind them of appointment and organise transport if needed. Following the ultrasound 2 vascular surgeons will be reporting on the scans and will immediately ring the research team. If at any time the patient is symptomatic they will be advised to wither go to the closet emergency department or their GP to organise a scan.