Compression stockings are a simple non-invasive treatment for varicose veins, chronic venous insufficiency, and lymphedema. The most effective option to prevent and treat lower limb varicose veins is to wear graduated compression stockings (GCSs). These stockings are called graduated because the pressure is higher at the ankle level and gradually decreased towards the heart.
Chronic venous insufficiency (CVI) in the lower limb is most commonly due to varicose veins, which appear as dilated, elongated, or tortuous superficial veins. Despite the considerable number of studies conducted on the aetiology of varicose veins, the reason is not known. However, it is generally recognized that occupation and posture are the major associated factors and contribute significantly to the effects of raised venous pressure and incompetence of primary structures in the vein wall and valves.
People who spend most of their working day in a standing or sedentary position (eg, police officers, teachers, sales assistants) are considered to be at a high risk for varicose vein development. The development of varicose veins usually occurs in the superficial venous system of the lower limbs, especially in the long saphenous veins (LSVs) and their tributaries. The short saphenous vein (SSVs) behind the knee and its tributaries can also become varicose, but this occurs less often. The reported incidence of varicose veins in adults varies from 7% to 40% in men and from 14% to 51% in women. If the condition cannot be prevented or treated in a timely manner, varicose veins can lead to more serious morbidities and medical complications.
The treatment compresses superficial veins to promote the flow of blood through the leg veins and prevent the accumulation of fluid (oedema) in the tissues of the legs.
| Note: To be effective, compression stockings must be worn regularly. |
Compression stockings, which are made from an elastic fabric, fit most tightly around the ankles and gradually become looser farther up the leg. The treatment compresses superficial veins to promote the flow of blood through the leg veins and prevent the accumulation of fluid what we call oedema in the tissues of the legs.
| Compression stockings are commonly used to treat or prevent: |
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Compression stockings are recommended or prescribed for moderate to severe CVI, following a procedure to treat varicose veins, or for lymphoedema in the leg.
Although many compression stockings are sold without a prescription, they should not be used without medical advice.
Pre-treatment Guidelines |
Patients with CVI or lymphedema may require bed rest for 2 to 7 days to reduce oedema (swelling) as much as possible. If the patient has infected leg ulcers, antibiotics may be prescribed. Ulcers (sores) are cleaned and dressed daily as needed. When swelling has decreased and any ulcers have healed, the patient is fitted with compression stockings. |
Who is eligible? |
Patients with impaired arterial circulation in the legs should not use compression stockings. |
Risk factors for possible complications |
Many patients have difficulty adjusting to compression stockings. They require daily use to be fully effective, yet they may initially cause great discomfort when they press against existing or recently healed ulcers. However, most patients can tolerate compression stockings by wearing the stockings briefly at first and gradually increasing the duration of wear. |
What to expect |
Patients are told they will need to wear the stockings at all times during the day and are therefore usually given two pairs of compression stockings to be able to wash them. The patient should put on the stockings in the morning before getting out of bed and wear them all day until bedtime. Special devices can ease the process of putting on compression stockings. |
Post-treatment Guidelines and Care |
Compression stockings generally have to be replaced every 3 to 6 months. Patients with CVI or severe varicose veins should be prepared to use compression stockings for the rest of their lives. |