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Compression Stockings – Effects, Classes and Uses

Compression stockings are medical garments that apply controlled pressure to the legs to improve blood circulation. They are used for venous insufficiency, edema, and prevention of deep vein thrombosis.

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Things worth knowing about "Compression Stockings"

Compression stockings are medical garments that apply controlled pressure to the legs to improve blood circulation. They are used for venous insufficiency, edema, and prevention of deep vein thrombosis.

What Are Compression Stockings?

Compression stockings are medical devices designed to apply a specific, graduated pressure to the leg. This pressure supports the venous return of blood toward the heart and helps prevent blood from pooling in the leg veins. They are available in various compression classes and lengths, ranging from knee-high to thigh-high stockings and full pantyhose.

Mechanism of Action

The principle of compression therapy is based on externally applied pressure that narrows the diameter of the veins. This increases the velocity of blood flow and improves venous return to the heart. At the same time, the pressure counteracts the leakage of fluid from blood vessels into the surrounding tissue, thereby reducing swelling (edema).

Compression Classes

Compression stockings are categorized into classes based on the pressure they exert:

Class I (15–21 mmHg): Light compression, suitable for tired, heavy legs and mild venous insufficiency.
Class II (23–32 mmHg): Moderate compression, commonly used for varicose veins, edema, and after vein surgery.
Class III (34–46 mmHg): Strong compression, for severe chronic venous insufficiency or significant edema.
Class IV (above 49 mmHg): Very strong compression, used in severe lymphatic disorders.

Indications

Compression stockings are recommended in a wide range of medical conditions and situations:

Chronic venous insufficiency (CVI): Weakness of venous valves leading to blood pooling in the legs.
Varicose veins: Enlarged, twisted veins that impair blood flow.
Thrombosis prevention: Prevention of deep vein thrombosis (DVT), for example during long flights or after surgery.
Edema: Fluid accumulation in the tissue, such as in lymphedema.
Pregnancy: Prevention of venous problems and leg swelling.
Post-operative care: After venous procedures or other surgical interventions.

Correct Use and Care

Compression stockings should ideally be put on in the morning before getting out of bed, as the legs are least swollen at this time. Special donning aids are available to make application easier. They may be removed and reapplied during the day as needed. Stockings should be washed daily and checked for damage, as a worn-out stocking loses its compression effectiveness.

Contraindications

In certain cases, compression stockings must not be worn. These include:

Severe arterial circulatory disorders (peripheral arterial occlusive disease)
Advanced heart failure
Severe neuropathy with impaired pain perception
Infections or open wounds on the legs

Medical consultation before using compression stockings is always advisable, especially for patients with underlying health conditions.

References

Deutsche Gesellschaft fuer Phlebologie und Lymphologie (DGPL): Guidelines on Compression Therapy, 2022.
Dissemond J. et al. - Compression Therapy. JDDG: Journal of the German Society of Dermatology, 2016.
World Health Organization (WHO): Prevention of Venous Thromboembolism. Available at: www.who.int

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