![]() The evidence for the benefit of graduated compression stockings in uncomplicated varicose veins was equivocal, and the published literature was often contradictory and had methodologic flaws.Ī Cochrane systematic review of graduated compression stockings for the initial treatment of varicosities in patients without venous ulceration (CEAP class C 2–C 4) included seven RCTs ( n = 356). 8 Textile properties, including fabric roughness, thermoregulation and dye, may contribute to skin reactions. For example, in CLOTS (Clots in Legs or Stockings after Stroke) trial 1 - a multicentre randomized controlled trial (RCT) that assessed the effectiveness of thigh-length graduated compression stockings to reduce the risk of deep vein thrombosis after stroke in about 2500 patients - skin breaks, ulcers, blisters and necrosis were significantly more common among patients wearing the stockings than among those not wearing them (5.1% v. 6, 7 Patients who are allergic to the stocking material may develop contact dermatitis, skin discoloration and blistering. The use of graduated compression stockings on legs with impaired arterial flow can worsen ischemia. Poorly fitting stockings can cause discomfort and, at worst, pressure necrosis. 6 – 9 The stockings are generally safe to use, with relatively few complications. The contraindications of graduated compression stockings are listed in Box 3. ![]() 4 Another study showed that levels of proinflammatory cytokines (e.g., interleukin-1α, interleukin-6 and interferon-γ) in ulcer tissue in patients with active ulcers were significantly reduced following compression therapy. ![]() 2, 4, 5 One study that used near-infrared spectroscopy to monitor changes in tissue oxyhemoglobin and deoxyhemoglobin reported that limb oxygenation increased with the use of graduated compression stockings, especially with high-compression stockings. 3 It also initiates complex physiologic and biochemical effects involving the venous, arterial and lymphatic systems, although the exact mechanisms remain unclear. 2 Graduation compression can reverse venous hypertension, augment skeletal-muscle pump, facilitate venous return and improve lymphatic drainage. The application of adequate graduated compression reduces the diameter of major veins, which increases the velocity and volume of blood flow. The pressure gradient ensures that blood flows upward toward the heart instead of refluxing downward to the foot or laterally into the superficial veins. The stockings work by exerting the greatest degree of compression at the ankle, with the level of compression gradually decreasing up the garment. As a result, the arterial pressure is increased, which causes more blood to return to the heart and less blood to pool in the feet.What are the mechanisms of action of compression stockings?įigure 2 summarizes the mechanisms of action of graduated compression stockings. By compressing the surface veins, arteries and muscles, they force circulating blood through narrower channels. Compression stockings are tightest at the ankles and gradually become less constrictive toward the knees and thighs. Unlike traditional dress or athletic stockings and socks, compression stockings use stronger elastics to create significant pressure on the legs, ankles and feet. They also aid in the treatment of ulcers of the lower legs. 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. Compression therapy helps decrease venous pressure, prevents venous stasis and impairments of venous walls, and relieves heavy and aching legs. This reduces the diameter of distended veins and increases venous blood flow velocity and valve effectiveness. Compression stockings are elastic garments worn around the leg, compressing the limb. Compression stockings are a specialized hosiery designed to help prevent the occurrence of, and guard against further progression of, venous disorders.
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