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.

INTERVENTION: 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 CONDITION: Deep Vein Thrombosis (DVT);Pulmonary Embolism (PE); ; Deep Vein Thrombosis (DVT) ; Pulmonary Embolism (PE) Surgery ‐ Other surgery PRIMARY OUTCOME: How many participants out of the 30 can we get to the 30 day Ultrasound Scan[30 day Ultrasound Scan follow‐up ] SECONDARY OUTCOME: Review of hospital medical record for admission with diagnosis of PE or VTE[up to day 30] INCLUSION CRITERIA: All patients 40 years and over undergoing elective major abdominal surgery with an anticipated length of stay greater than 24 hours and able to attend a 30‐day follow‐up bilateral lower leg venous ultrasound.