Graduated compression stockings

Graduated Compression Stockings

Graduated compression stockings are specialized hosiery designed to improve blood circulation in the legs. They are commonly used in the prevention and treatment of various venous disorders, including deep vein thrombosis (DVT), chronic venous insufficiency, and varicose veins. These stockings apply the greatest amount of pressure at the ankle, with gradually decreasing pressure up the leg, which helps to promote venous return and reduce venous pressure.

Mechanism of Action

Graduated compression stockings work by exerting external pressure on the legs, which compresses the surface veins, arteries, and muscles. This compression helps to:

• Enhance Venous Return: By applying pressure, the stockings help to push blood back towards the heart, reducing the risk of blood pooling in the lower extremities.
• Reduce Venous Pressure: The pressure gradient helps to decrease venous pressure, which can alleviate symptoms of venous disorders.
• Prevent Venous Stasis: By promoting blood flow, these stockings help to prevent the stagnation of blood, which is a risk factor for clot formation.

Indications

Graduated compression stockings are indicated for a variety of conditions, including:

• Deep Vein Thrombosis (DVT) Prevention]]: Especially during long periods of immobility, such as during travel or post-surgery.
• Chronic Venous Insufficiency: To manage symptoms such as swelling, pain, and skin changes.
• Varicose Veins: To alleviate discomfort and prevent progression.
• Lymphedema: To reduce swelling associated with lymphatic system disorders.

Contraindications

While generally safe, graduated compression stockings are contraindicated in certain conditions, such as:

• Severe Peripheral Arterial Disease: Compression can further reduce blood flow in already compromised arteries.
• Severe Congestive Heart Failure: The increased venous return can exacerbate heart failure symptoms.
• Skin Infections or Dermatitis: Compression can worsen skin conditions.

Types and Classes

Graduated compression stockings are available in various lengths, including knee-high, thigh-high, and full-length. They are also classified by the level of compression they provide, measured in millimeters of mercury (mmHg):

• Mild Compression (8-15 mmHg): Suitable for minor swelling and fatigue.
• Moderate Compression (15-20 mmHg): Often used for mild varicose veins and during pregnancy.
• Firm Compression (20-30 mmHg): Commonly prescribed for moderate varicose veins and post-surgical use.
• Extra Firm Compression (30-40 mmHg): Used for severe venous insufficiency and lymphedema.

Fitting and Usage

Proper fitting is crucial for the effectiveness of graduated compression stockings. They should be measured and fitted by a healthcare professional to ensure the correct size and compression level. Patients are typically advised to:

• Wear them during the day: Put them on in the morning and remove them before bed.
• Avoid wrinkles: Ensure the stockings are smooth against the skin to prevent pressure points.
• Replace regularly: Stockings should be replaced every 3-6 months as they lose elasticity over time.

Also see

• Deep vein thrombosis
• Varicose veins
• Chronic venous insufficiency
• Lymphedema