Compression Stockings Research Articles

Management of Peripheral Edema in Patients with MET Exon 14-Mutated Non-small Cell Lung Cancer Treated with Small Molecule MET Inhibitors.

Small molecule mesenchymal-epithelial transition (MET) inhibitors, such as crizotinib, capmatinib, and tepotinib, are treatment options for metastatic non-small cell lung cancer (NSCLC) in adult patients whose tumors have a mutation that leads to MET exon 14 skipping. In clinical trials, these MET inhibitors were associated with a high incidence of peripheral edema, although this was generally mild-to-moderate in severity. There is limited information about the mechanism involved in MET inhibitor-induced peripheral edema. Perturbation of hepatocyte growth factor (HGF)/MET signaling may disrupt the permeability balance in the vascular endothelium and thus promote edema development. Another potential mechanism is through effects on renal function, although this is unlikely to be the primary mechanism. Because edema is common in cancer patients and may not necessarily be caused by the cancer treatment, or other conditions that have similar symptoms to peripheral edema, a thorough assessment is required to ascertain the underlying cause. Before starting MET-inhibitor therapy, patients should be educated about the possibility of developing peripheral edema. Patient limb volume should be measured before initiating treatment, to aid assessment if symptoms develop. Since the exact mechanism of MET inhibitor-induced edema is unknown, management is empiric, with common approaches including compression stockings, specific exercises, massage, limb elevation, and/or diuretic treatment. Although not usually required, discontinuation of MET inhibitor treatment generally resolves peripheral edema. Early diagnosis and management, as well as patient information and education, are vital to decrease the clinical burden associated with edema, and to reinforce capmatinib treatment adherence.

The Efficacy of Compression Stockings on Patients With Nocturia: A Single-Arm Pilot Study

Objectives: Behavioral treatment for nocturia includes wearing compression stockings. However, a reading of the cited literature for evidence shows that there is not enough research data to support this recommendation, and it is controversial. The present study aimed to investigate and supplement evidence on the effects of wearing compression stockings during the daytime in patients with nocturia.Methods: This was a single-arm prospective study to investigate the effects of compression stockings on nocturia for four weeks. Patients were asked to record a frequency-volume chart and complete various questionnaires at baseline and after four weeks, and also provide feedback on treatment satisfaction. The primary endpoint was a change in night-time frequency in the frequency-volume chart from the baseline to the end of treatment.Results: Thirty-four patients (19 men and 15 women; age: 72.3 ± 12.6 years) were included. Two patients dropped out because of pain associated with wearing compression stockings and one due to a refusal to wear compression stockings every day. Therefore 31 patients were analyzed. In the frequency-volume chart, night-time and 24-hour frequencies significantly decreased by 0.5 and 1.1 episodes, respectively (P = 0.004 and P = 0.035, respectively). The hours of undisturbed sleep significantly increased by 0.8 h (P = 0.013). No significant differences were observed in nocturnal or 24-h urine volumes, the number of urgency or urinary incontinence episodes, the mean or maximum voided volume, the nocturnal polyuria index, or the first night-time voided volume. The total overactive bladder symptom score significantly decreased (P = 0.006). Significant reductions were also observed in all overactive bladder symptom score subscores, except for the daytime frequency score.Conclusion: The present results suggest the effectiveness of wearing compression stockings during the day was satisfactory in most patients with nocturia, and the treatment was safely continued in patients who experienced no pain when wearing the stockings. Based on the results of this study, we believe that it is worth considering as a treatment for nocturia.

Interventions for preventing venous thromboembolism in adults undergoing knee arthroscopy.

Interventions for preventing venous thromboembolism in adults undergoing knee arthroscopy.

214 Laparoscopic Cholecystectomy: Most Primeval and Pervasive Yet Least Congruent

Abstract Aim Laparoscopic Cholecystectomy is one of the commonest surgical procedures performed worldwide. However, there is considerable variation in laparoscopic cholecystectomy practice, and a lack of robust data on variations in practices. Method A 45-item electronic survey was designed to capture global variations in practice of laparoscopic cholecystectomy. The survey was disseminated to the global community of surgeons performing laparoscopic cholecystectomy through professional surgical and training organizations and social media. Results 638 surgeons from 70 countries completed the survey. Pre-operatively 5.6% routinely performed an endoscopy to rule out peptic ulcer disease. Cholecystectomy theatre lists were provided acutely by 58.6%, with 61.2% (n=389) performing index admission cholecystectomy for gallstone pancreatitis. Peri-operative practice included the use of prophylactic antibiotics (n=362) and elastic compression stocking routinely by over half of the respondents. However, 69.7% do not use pharmacological DVT prophylaxis preoperatively. Open juxta umbilical is the preferred method of pneumoperitoneum (n=410, 64.6%). The most common approach to difficult Calot's triangle is retrograde dissection from fundus (49.2%, n= 312). Transection of the gallbladder in the middle and retrograde dissection is practiced by about 18% of surgeons (n=114). Local anesthetic is instilled into the gallbladder bed by 14.2% of surgeons. Half of the surgeons discharge their patients on the following day, while around 44% would discharge them on the same day. Conclusions This study highlights significant variations in practices concerning various aspects of laparoscopic cholecystectomy and stressed on the need for developing consensus guidelines.

Shank Circumference Reduction by Sleep Compression Stockings in University Students and Convenience Store Cashiers.

Compression stockings (CSs) are a relatively simple and effective tool for alleviating varicose veins and are often used as a preventive measure among workers whose jobs require prolonged standing. Nevertheless, the efficacy of CSs that are advertised as sleepwear remains unverified. This study recruited 10 female university students and 10 cashiers as participants to test the effects of sleep CSs. During the experiment, the changes in shank circumference (SC) and the subjective discomfort rating upon getting up and going to bed were collected. Data were recorded immediately after getting up and SC measurement was repeated 10 min later. The results demonstrated that both CS condition and measurement time significantly affected SC reduction, whereas cashier or student status did not. The reported discomfort and tightness of the legs attributed to CSs were relatively high, and the benefit toward SC reduction was minimal. Cashiers exhibited slightly larger SC values and higher perceived discomfort levels, which may be attributed to their occupational characteristic of prolonged standing, and the cumulative effect of prolonged standing on muscle properties warrants further study. The study findings suggest that wearing CSs for sleep may not be effective for reducing OE

Thigh-length graduated compression stocking cannot increase blood velocity of the common femoral vein in patients awaiting total hip arthroplasty

ObjectivesGraduated compression stocking (GCS) is one of the mechanical prophylaxes commonly used for deep vein thrombosis (DVT). The present study was designed to observe the effects of graduated compression stockings on the vein deformation and hemodynamics of lower limbs in patients awaiting total hip arthroplasty (THA).MethodsThe lower extremity veins of 22 patients awaiting THA were examined by ultrasound, when they rested in supine position with or without thigh-length GCS. The deformation parameters we measured included antero-posterior (AP) diameters, latero-medial (LM) diameters, and cross-sectional area (CSA) of great saphenous vein (GSV), posterior tibial vein (PTV), popliteal vein (PV), gastrocnemius vein (GV), and superficial femoral vein (SFV). We measured peak velocity and mean velocity of GSV, common femoral vein (CFV), junction of GSV and CFV to represent for hemodynamics of veins.ResultsSignificant compression was observed in almost all measured veins with the use of thigh-length GCS, while it was unable to significantly compress GSV in latero-medial diameter. The mean latero-medial diameter reductions for GSV, PTV, GV, PV and SFV were 19.4, 30.2, 43.2, 29.7 and 20.4%, respectively. GCS significantly compressed antero-posterior diameter of GSV, PTV, GV, PV and SFV by 43.4, 33.3, 42.1, 37.5, and 27.8%, respectively. The mean reduction of cross-section area was 44.8% for GSV, 49.6% for PTV, 60.0% for GV, 57.4% for PV, and 36.2% for FV. No significant changes were observed in the mean blood velocity of GSV, CFV, and junction. GCS was able to significantly reduce peak velocity of CFV (17.6 ± 5.6 cm/s to 16.1 ± 6.0 cm/s) and junction (23.3 ± 9.5 cm/s to 21.3 ± 9.7 cm/s), while it did not change the peak velocity of GSV.ConclusionThigh-length GCS is sufficient to compress lower extremity veins in patients awaiting THA in supine position with the greatest compression in GV, while it was unable to significantly increase blood velocity of common femoral vein or GSV. GCS may prevent DVT through more than simply increasing blood flow. Further studies are needed to determine the specific effects of GCS.

Patient-specific medical compression stockings (MCSs) development based on mathematic model and non-contact 3D body scanning

Medical compression stockings failed or didn’t reach expected positive functions in practical uses, one of the reasons is related to the inaccurate or inappropriate of pressure distributions. Three-dimensional (3D) scanning and analysis were carried out to extract human anthropometric data. Knitting parameters were engineering designed and theoretical pressure profiles were predicted by mathematical models, according to integrative considerations of Standard, leg morphology and machine parameter setting. The predicted pressure distributions for Class I, II & III MCSs generally in predefined ranges. The actual measured pressure values were greater than predicted at all tested regions for Series 1 of MCSs. The MCSs combined structure A and B at calf region make the effect of homogenizing pressure around calf cross-section. It's feasible and valuable to develop MCSs based on knitting parameters, 3D body scanning individually and pre-defined pressure distribution ergonomically to match directly patient-specific medical requirements and healthcare.

A realist evaluation to identify targets to improve the organization of compression therapy for deep venous thrombosis- and chronic venous disease patients.

BackgroundAlthough compression therapy is well established for patients with deep venous thrombosis (DVT) and chronic venous disease (CVD), considerable variation exists in its organization in clinical practice which may impact patient outcomes. The current study aims to deepen our understanding of the main drivers of the complex care organization for compression therapy and to identify targets for improvement.MethodsThis realist evaluation includes a mixed-method design consisting of semi-structured interviews with patients and health care professionals involved in compression therapy (n = 30), stakeholder meetings (n = 2) and surveys (n = 114). Data were collected to create the content of context-mechanism-outcome-configurations (CMOcs) important in compression therapy. Based on these CMOcs, targets for improvement to optimize the organization of compression care were identified.ResultsWe identified overarching context factors and mechanisms targeting four optimal outcomes for the organization of compression therapy: selecting initial compression therapy types that support patient’s self-reliance (1), evidence based selection of elastic compression stocking type and class (2), patient-based selection of assistive devices (3), individualizing treatment duration for DVT patients (4a) and providing follow-up for CVD patients (4b). We found that increasing health care professionals’ knowledge of compression therapy, the availability of unambiguous protocols and guidelines, increasing patient involvement (and if applicable their informal care giver) in the decision making process, the accessible availability of resources, and increasing interdisciplinary consultation enhanced desirable outcomes. These targets triggered mechanisms such as increased health care professionals’ willingness, confidence and motivation to provide patient-based care and increased patients’ self-confidence and self-efficacy.ConclusionsThis study provides a detailed insight into what needs to be in place to optimize compression care and identified five main targets for improvement.

Personal factors and postoperative changes in the revised Venous Clinical Severity Score of varicose veins

ObjectiveThe primary aim of this observational study was to measure the Revised Venous Clinical Severity Score (rVCSS) in patients treated for varicose veins (VVs) owing to saphenous vein reflux. Treatment was by endovenous thermal ablation (ETA) alone or by ETA and ambulatory phlebectomy (AP). A secondary aim was to determine whether participant characteristics and treatment methods affect rVCSS and how the score changes over time. MethodsWe enrolled 44 men with 55 treated legs and 79 women with 105 treated legs (bilateral cases, 23.1%). Patients were treated and evaluated from April 2016 to September 2020. All legs were treated by ETA, and participants were divided into three groups depending on AP treatment: E0 group (40 legs), no AP; EP1 group (101 legs), AP performed only at one site above or below the knee; and EP2 group (19 legs), AP performed both above and below the knee. The rVCSS was measured in the treated legs up to five times: preoperatively and on postoperative days (POD) 1, 7, 90, and 180. ResultsThe mean age was 67.5 ± 11.24 years (range, 32-87 years). No significant differences in medical history or demographics or lifestyle were found between the groups. The mean preoperative rVCSS also was not different between groups (E0, 4.4 ± 0.3 points; EP1, 4.6 ± 0.2 points; and EP2, 5.4 ± 0.4 points; P = .14). Factors associated with less improvement in the rVCSS were a high body mass index (P = .046) and the occurrence of endovenous heat-induced thrombosis (P = .001), and factors associated with more improvement in the rVCSS were hypertension (P = .026), hyperuricemia (P = .022), and wearing compression stockings (P = .013). The rVCSS decreased strongly at POD1 and then gradually decreased until POD180. It was not significantly different between EP1 and EP2, but it improved significantly earlier in these two groups than in the E0 group. The rVCSS at POD180 was as follows: E0, 1.633 ± 0.233 points; EP1, 1.003 ± 0.148 points; and EP2, 0.982 ± 0.322 points. ConclusionsFactors associated with less improvement in the rVCSS are a high body mass index and the occurrence of endovenous heat-induced thrombosis. Hypertension, hyperuricemia, and wearing compression stockings are associated with greater improvements in the rVCSS. Patients treated with ETA and AP tend to improve earlier than patients treated by ETA alone, but all patients improve to nearly the same level within 6 months.

Renal Transplantation in Pure Autonomic Failure.

Renal Transplantation in Pure Autonomic Failure.

Material, structure, and design of textile-based compression devices for managing chronic edema

Background: Compression bandages, stockings, and pneumatic compression devices are common classifications of compression products, used alone or in combination. The structure of these compression products is complex: they are typically multi-layered, overlapped, stretched and applied to a three-dimensional curved surface part of the body. This research aims to review the materials, designs, and fabrication processes/technologies of a variety of compression devices used in management of chronic edema by considering contributions of materials/textiles, as well as prototyping technologies. Method: Relevant papers/patents for review were identified using keywords associated with materials, designs, and fabrication processes of textile-based compression devices/products for treatments of the edematous lower limb. Results: Modern Compression therapies employ textile materials with a variety of fiber types, yarns and fabric structures, and wide range of elasticity and extensibility (i.e. inelastic to elastic, short stretch to long stretch) to provide the required pressure to the lower leg. Compression fabrics are fabricated using a variety of production technologies and machineries, and they have a wide range of physical and performance attributes. Conclusions: Appropriate selection of materials and fabrication technologies for use in compression therapy is essential to enhance the success in the management of chronic edema. This review might aid in the development and implementation of textiles/materials, and improvement in design of the textile-based compression devices to increase the efficacy of compression therapies in the management of chronic edema, allowing patients to improve their long-term health.

Antiplatelet agents for the treatment of deep venous thrombosis.

Antiplatelet agents for the treatment of deep venous thrombosis.

Wear Trials about Comfort on Sport Compression Socks

Compression garments has emerged as an important tool in sport activity [1, 2]. In the particular case of compression socks (CS), several studies show that their use improves the fatigue recovery and prevents muscle injuries [3-6]. The aim of this research work is to perform the characterization of sports socks regarding their comfort and compression. Several parameters were monitored in volunteers during a running test. This test was performed in a non-inclined treadmill for 12 minutes at 12km/h. PicoPress equipment was used to recording the compression force; Thermodata sensors were used to monitor the temperature and humidity; Wrist pulse oximeter was used to measure the oxygen saturation and heart rate; and thermal imaging with a TESTO IR camera was used for thermal component evaluation. Wearing compression socks seem to return better conditions for comfort, muscle stability and muscle fatigue because the main conclusions of the test show that the volunteers feel better at muscle stability (MS) and no fatigue after 24 hours of running.

A meta-review of the impact of compression therapy on venous leg ulcer healing.

This meta-review aimed to appraise and synthesise findings from existing systematic reviews that measured the impact of compression therapy on venous leg ulcers healing. We searched five databases to identify potential papers; three authors extracted data, and a fourth author adjudicated the findings. The AMSTAR-2 tool was used for quality appraisal and the certainty of the evidence was appraised using GRADEpro. Data analysis was undertaken using RevMan. We identified 12 systematic reviews published between 1997 and 2021. AMSTAR-2 assessment identified three as high quality, five as moderate quality, and four as low quality. Seven comparisons were reported, with a meta-analysis undertaken for five of these comparisons: compression vs no compression (risk ratio [RR]: 1.55; 95% confidence interval [CI] 1.34-1.78; P< .00001; moderate-certainty evidence); elastic compression vs inelastic compression (RR: 1.02; 95% CI: 0.96-1.08; P< .61 moderate-certainty evidence); four layer vs <four-layer bandage systems (RR: 1.07; 95% CI: 0.82-1.40; P< .63; moderate-certainty evidence); comparison between different four-layer bandage systems (RR: 1.08; 95% CI: 0.93-1.25; P= .34; moderate-certainty evidence); compression bandage vs compression stocking (RR 0.95; 95% CI 0.87-1.03; P= .18; moderate-certainty evidence). The main conclusion from this review is that there is a statistically significant difference in healing rates when compression is used compared with no compression, with moderate-certainty evidence. Otherwise, there is no statistically different difference in healing rates using elastic compression vs inelastic compression, four layer vs <four-layer bandage systems, different four-layer bandage systems, or compression bandages vs compression stockings.

Postural orthostatic tachycardia syndrome as a sequela of COVID-19.

Postural orthostatic tachycardia syndrome (POTS) is a complex multisystem disorder characterized by orthostatic intolerance and tachycardia and may be triggered by viral infection. Recent reports indicate that 2%–14% of coronavirus disease 2019 (COVID-19) survivors develop POTS and 9%–61% experience POTS-like symptoms, such as tachycardia, orthostatic intolerance, fatigue, and cognitive impairment within 6–8 months of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Pathophysiological mechanisms of post–COVID-19 POTS are not well understood. Current hypotheses include autoimmunity related to SARS-CoV-2 infection, autonomic dysfunction, direct toxic injury by SARS-CoV-2 to the autonomic nervous system, and invasion of the central nervous system by SARS-CoV-2. Practitioners should actively assess POTS in patients with post–acute COVID-19 syndrome symptoms. Given that the symptoms of post–COVID-19 POTS are predominantly chronic orthostatic tachycardia, lifestyle modifications in combination with the use of heart rate–lowering medications along with other pharmacotherapies should be considered. For example, ivabradine or β-blockers in combination with compression stockings and increasing salt and fluid intake has shown potential. Treatment teams should be multidisciplinary, including physicians of various specialties, nurses, psychologists, and physiotherapists. Additionally, more resources to adequately care for this patient population are urgently needed given the increased demand for autonomic specialists and clinics since the start of the COVID-19 pandemic. Considering our limited understanding of post–COVID-19 POTS, further research on topics such as its natural history, pathophysiological mechanisms, and ideal treatment is warranted. This review evaluates the current literature available on the associations between COVID-19 and POTS, possible mechanisms, patient assessment, treatments, and future directions to improving our understanding of post–COVID-19 POTS.

High-performance fibrous artificial muscle based on reversible shape memory UHMWPE

Shape memory polymer fibers (SMPFs) are an important branch of intelligent fibers. Due to their ability to deform under external stimuli, shape memory polymer fibers have been used in intelligent textiles, polymer fillers and medical fields, including surgical sutures, thrombectomy devices, compression stockings, etc. There have been many studies on SMPFs, but almost all reported SMPFs only exhibit a one-way shape memory effect (SME). The deformation process of the one-way SMPFs is irreversible, and the transition from temporary shape to permanent shape cannot be replicated by simply reversing the stimulus. To tackle this problem. We selected ultra-high molecular weight polyethylene (UHMWPE) as the polymer matrix to prepare external stress-free two-way SMPFs. UHMWPE powders are gel-spun and then hot drawn to yield raw UHMWPE fibers. After programming, the UHMWPE fibers possess high tensile strength (338.72 MPa) and Young's modulus (2287.34 MPa), as well as one-way SME, quasi two-way SME and external stress-free reversible two-way SME. The reversible strain of the prepared reversible shape memory UHMWPE fibers is 27.42%. Artificial muscles and actuators can be made from the programmed UHMWPE fibers. The programmed UHMWPE fibers can lift more than 250 times their own weight with ∼10% reversible strain. The programmed UHMWPE fibers are appropriate for industrial mass production since the preparation and programming processes are simple.

Impact of Sub-Clinical and Clinical Compression Socks on Postural Stability Tasks among Individuals with Ankle Instability.

Compression socks are used by a very diverse group of individuals and may potentially have a greater impact on physically diminished or impaired individuals as opposed to healthy individuals. The purpose of this study was to compare the effects of sub-clinical (SC) and clinical (CL) compression socks among healthy (CON), copers (COP), and individuals with chronic ankle instability (CAI). Postural stability was evaluated in 20 participants (11 males and 9 females) using Balance Tracking System Balance platform (BTrackS™) during the modified clinical test of sensory integration in balance (mCTSIB) and limits of stability (LOS) tests. Postural sway parameters were analyzed using a mixed model repeated measures analysis of variance 3 (group: CON, COP, and CAI) by 3 (compression condition: BF, SC, and CL) × 4 (balance condition: EO, EC, EOF, and ECF) for mCTSIB and a 3 (group: CON, COP, and CAI) by 3 (compression condition: BF, SC, CL) × 4 (balance condition: FL, BL, BR, FR) for LOS. Results revealed significantly greater postural stability with both SC and CL compression socks when compared to barefoot conditions. However, no significant differences were observed among groups for compression socks grades. Both SC and CL compression socks may be effective in increasing postural stability.

Graduated Compression Stockings for Deep Vein Thrombosis prevention in Surgical Patients: A Systematic Review

Introduction. Oral anticoagulant therapy is commonly used to prevent deep vein thrombosis (DVT). However, it might increase the risk of intraoperative and postoperative bleeding. Graduated compression stockings (GCS) reduced DVT risk, but there is a lack of supporting evidence. Thus, the study aimed to find the efficacy of GCS compared to the pharmacological method in high-risk surgical patients.

Early Results With a New Endovenous Radiofrequency Ablation Catheter, Venclose®

Endovenous Radio-frequency Ablation (RFA) has become a common treatment for chronic venous insufficiency. The Medtronic® Closurefast catheter was previously the only RFA catheter approved for use in this procedure. In 2018 VenClose® Company's new device was approved. As there has been little literature on this new device, we examined our results with this new alternative. Patients with symptomatic venous insufficiency had their lower extremities mapped via ultrasound. If superficial reflux (>.5 s) was found the patients were recommended a 6-week conservative course of compression stockings, elevation, and NSAIDs. If conservative treatment failed, the patient was scheduled for an RFA. The procedure was done at the outpatient clinic, instructions were given to return for follow-up in 3-5days, and every 3months thereafter for the first year. 1032 procedures were performed over 14months. We had 503 patients, 69% female, mean age 54 ± 12. Under the CEAP system, clinical manifestation portion, the majority of our limbs were class C3 and class C4. The majority of veins closed were GSV above knee and SSV. Follow-up duration ranged from 1 to 276days (Mean (M) = 10 SD: 20days). Our success rate was 99.32% at initial follow-up. We observed EHITs in 12 cases (1.16%), 8 of which were class I, 2 of which were class II, and 2 of which were class III. We noted SVTs of proximal varicose veins in 40 cases (3.88%) and SVT of distal GSV in 4 cases (.38%). There were 4 (.38%) cases of DVT, 3 in calf muscular veins (.29%), and one in a perforator vein (.09%). We observed two cases of puncture abscess (.193%), 8 cases of infection at the puncture site (.77%), with 8 infections occurring at locations other than the puncture site and not as a result of the procedure. These preliminary results indicate that this new machine and catheter are promising with low rates of EHIT, recanalizations, and other complications. It is important to research this catheter and further studies should continue to follow up to examine recanalization rates over a more long-term follow-up.

Washing Characterization of Compression Socks

Abstract Background Compression socks are highly recommended textile garments for the exertion of compression pressure (kPa) at the ankle. They work on the principle of the highest pressure at the ankle gradually decreasing from the ankle to the calf. Aim The aim of the current research is to analyze all of the compression sock samples (Class I, Class II, and Class III) simultaneously at various number of times of washing them. Method All of the sock samples were washed in a standard washing machine with standard methods (ISO 6330). For the measurement of the compression pressure, a Salzmann MST MKIV pressure measuring device was used according to the RAL-GZ 387/1 method. Results Results included the effect of multiple wearing and washing cycles (up to 20) on compression pressure, the effect of temperature (up to 100°C) on compression pressure (kPa); multiple wearing and washing cycles on the percentage of shrinkage and the effect of marking methodology on compression pressure (Kpa) were observed and are discussed in this article. The results suggest that washing is the most important factor to consider while compression socks are used for compression therapy because they directly influence the efficacy of streamline blood flow across the legs.