Use Of Compression Stockings Research Articles

A qualitative study of barriers and facilitators to compression stocking use in patients with chronic venous insufficiency.

Compression stocking therapy is the gold standard of treatment for conditions associated with lower limb venous dysfunction. The benefits in symptom relief and preventing disease progression are well documented. Despite this, adherence to compression stocking therapy is poor. This project aimed to identify factors affecting compression stocking adherence in Aotearoa New Zealand through qualitative evaluation of interviews of patients with chronic venous insufficiency. In this mixed-methods study, 25 participants were recruited, and semi-structured interviews were carried out until thematic saturation was reached. All participants also took part in surveys recording characteristics and Quality of Life questionnaires. Common interview themes were summarized and quality of life scores were compared between respondents. Interview respondents were a median of 64 years old, and were prescribed compression therapy a median of 8 years prior. The cohort spent a median of 8 h a day standing. Qualitative interviews identified three main themes influencing compression stocking use: physical factors, psychological factors and external factors. Subthemes included the influence of age and sex on participant perceptions of the stockings' appearance, and how comorbidities contribute to donning difficulty. Understanding factors influencing patient adherence can enable clinicians to provide a multidimensional approach, mitigating barriers and emphasizing facilitators for the individual patient to improve adherence.

Obstetric management for pregnant women with Klippel-Trenaunay syndrome: A UK case report and review of the literature.

Klippel-Trenaunay Syndrome (KTS) is a rare congenital vascular disorder characterized by extensive capillary and venous malformations that pose unique challenges during pregnancy. This case report discusses the successful management of a 34-year-old pregnant woman with KTS who had two caesarean sections, resulting in the birth of two healthy babies. Despite the lack of evidence-based guidelines for obstetrical management in KTS, a multidisciplinary team collaborated to devise a high-risk thrombosis management plan, involving the use of compression stocking and low molecular weight heparin prophylaxis. The patient's elevated risk of thrombosis, exacerbated during pregnancy, informed the decision of caesarean sections, aligning with finding that in most KTS pregnancies, this method of delivery based on obstetric indications and arteriovenous malformations is chosen. This case highlights the importance of systematic and patient-centered care, advocating for comprehensive obstetric management guidelines to address the unique challenges posed by KTS during pregnancy. Further research is warranted to enhance our understanding and refine guidelines for individuals with vascular abnormalities linked to KTS.

Effects of a Dietary Supplement Composed of Baicalin, Bromelain and Escin for Venous Chronic Insufficiency Treatment: Insights from a Retrospective Observational Study.

Chronic venous insufficiency (CVI) represents a risk factor for cardiovascular events. The first-line treatment includes the use of compression stockings and lifestyle changes. Natural products, such as flavonoids, could be used to improve the effects of compression therapy due to their anti-inflammatory and anti-oxidant properties. This study aims to evaluate the effects of a dietary supplement containing baicalin, bromeline and escin in CVI patients. A retrospective cohort study was performed by using the medical records of CVI affected outpatients. Patients treated with the dietary supplement were defined as "users". A modified Venous Clinical Severity Score (VCSS) was calculated, including pain, inflammation, vessels induration and skin pigmentation. All clinical variables were evaluated at baseline (T0), after 30 (T1) and 90(T2) days in "users" and "non-users". Out of 62 patients, 30 (48.4%) were "users". No difference was observed between groups at baseline. A lower VCSS value was recorded in "users" than that observed in "non-users" at T2 (7.0 (4.0-9.0) vs. 9.0 (5.0-10.0); p = 0.025). Vessels' induration and pain significantly reduced in 53.3% and 43.3% of "users" and in 18.8% and 9.4% of "non-users". Only "users" (33.3%) showed a reduction of the inflammatory signs as well as a decrease in malleolar circumference, from 29.0 (26.5-30.0) to 27.5 (26.0-28.5) (p < 000.1). A reduction of C-reactive Protein levels was found in "users" compared to "non-users" at T2 (1.0 (0.9-1.2) vs. 1.3 (1.0-1.5); p = 0.006). These findings suggest that implementation of a dietary supplement could improve the clinical outcomes of CVI patients.

Endovascular laser ablation management of pediatric Klippel trenaunay syndrome: a case report

Introduction: Klippel trenaunay syndrome (KTS) is a rare and complex congenital vascular anomaly as a combination of vascular capillary malformations (port wine stain), venous malformations (VM) and excessive extremity growth with or without lymphatic malformations. The incident KTS is estimated to be 2 to 5 per 100,000 and found in the male gender without distinguishing race. This syndrome is rare, with a low incidence. Klippel trenaunay syndrome uses conservative management with the use of compression stockings. Other KTS management, such as minimally invasive intervention with endovascular laser ablation (EVLA) therapy, is rarely used due to the rare number of diseases. Thus, this study aims to perform the management of KTS in pediatrics. Case description: We report 11-year-old girls complaining of pain and swelling on the right leg when standing long and doing activities. Physical examination appears to show a purplish-red birthmark that arises on the surface of the skin. Ultrasound and CT scan angiography with contrast in the lower region extremities showed hypertrophy accompanied by peripheral branches in the cutaneous layer. Patients are performed endovascular laser ablation using general anesthesia. After endovascular laser ablation, the patient was treated for 2 days without any complaints. Conclusion: KTS is a rare, complex and varied syndrome that has not been found yet. KTS only performs symptomatic treatment depending on clinical and severity. Endovascular laser ablation is a minimally invasive intervention management that must be considered and has a fairly low risk and complication, especially in pediatrics.

The Frail Elderly Patient and the Need for a Video Store on Regional Anaesthesia Blocks

The Frail Elderly Patient and the Need for a Video Store on Regional Anaesthesia Blocks

The Impact of Obesity and Patient-Reported Reasons on Patient Noncompliance with Compression Stockings

Introduction: The aim of this study is to investigate the impact of obesity on patient compliance with elastic compression stockings and to reveal patient behavior-related and compression stockings-related factors for noncompliance. Patients and Methods: Between July and August 2022, a total of 246 patients with chronic venous insufficiency were included in the study. The patients were divided into two groups, obese and non-obese patients (88 vs. 158 patients), and questioned for proper use of compression stockings and the patient-reported reasons for the non-compliance. Results: The mean age was 49.0 ± 13.1, and the mean BMI was 28.6 ± 5.2. Only 51 patients (20.7%) out of 246 complied with stocking use. The mean number of days per week in which the compression stockings were properly used was 2.9 ± 1.7 in the study population. Patient compliance was higher in the non-obese group (12.5% vs. 25.3%, p= 0.017), and the number of days per week in which the compression stockings were worn properly was higher in the non-obese group (2.6 ± 1.3 vs. 3.1 ± 1.9, p= 0.032). Conclusion: The compliance of our patients with elastic compression stockings was found to be as low as 20.7%. Compliance was lower in the group of obese patients. Obesity and diabetes mellitus were the only factors associated with noncompliance in univariate logistic regression analysis. Further studies are needed in larger patient populations to increase the rate of patient compliance.

The Use of Compression Stockings to Reduce Water Retention in the Legs During Gaming and Esports: Randomized Controlled Field Study.

BackgroundWith the increasing digitalization of daily life, internet-based entertainment such as gaming and streaming has advanced to one of the megatrends of the 21st century. Besides offering a multitude of controversially discussed opportunities for entertainment and social interaction, there is reasonable concern about health issues caused by the absence of physical activity among activities linked to gaming and streaming.ObjectiveThe aim of this study is to compare the water balance of recreational gamers with and those without compression stockings during a gaming event.MethodsWe measured body composition and water balance with 8-electrode bioelectrical impedance analysis among 46 recreational gamers with an average age of 27.1 (SD 6.5) years (5/46, 11% women and 41/46, 89% men) before and after 24 hours at a gaming event. Of the 46 gamers, 23 (50%) gamers wore compression stockings for the duration of the study.ResultsOur study shows that prolonged gaming and associated behaviors during a 24-hour time frame lead to an increase in total body water (+0.76 L; P<.001) and a decrease of phase angle in the lower extremities (−0.47°; P<.001) but not in the upper extremities (+0.09°; P=.80), when no compression is used. Gamers using compression socks did not show any significant negative effects on their body composition.ConclusionsProlonged gaming and streaming are serious risk factors for diseases associated with water retention in the legs, and these risks can be measured by bioelectrical impedance and reduced by wearing compression stockings. We conclude that these findings should be discussed and replicated in larger studies and that there is a considerably large market for compression stockings among gamers and live streamers.

Measurement of Skin Thickness Using Ultrasonography to Test the Usefulness of Elastic Compression Stockings for Leg Edema in Pregnant Women.

Background: One of the most common treatments for leg edema during pregnancy is the use of compression stockings. The purpose of this study was to evaluate the objective effectiveness in pregnant women, by measuring the changes of skin thickness using ultrasonography. Methods: Pregnant women were diagnosed with leg edema using the pitting edema method at 36 weeks of gestation. Twenty-four pregnant women (48 legs) with leg edema spent time without wearing elastic stockings at 36–37 weeks of gestation. Then, they wore elastic stockings for one week at 37–38 weeks of gestation. We measured the grade of edema (from 0 to 3) and the skin thickness of the lower leg by portable ultrasonography at 36, 37, and 38 weeks of gestation (a before-and-after study). Results: In 24 pregnant women, thigh edema was not detected in any of the 48 legs before or after the use of elastic stockings. All 48 legs in 24 pregnant women had physiological lower leg edema, but not thigh edema. The average grade of pitting edema in each lower leg significantly decreased after using the stockings (36 weeks, 1.77 ± 0.85; 37 weeks, 1.79 ± 0.77; 38 weeks, 1.04 ± 0.74, p < 0.0001). In addition, the skin thickness of the lower legs was significantly decreased after the use of elastic stockings (36 weeks, 7.47 ± 2.45 mm; 37 weeks, 7.93 ± 2.83 mm; 38 weeks, 7.15 ± 2.35 mm, p < 0.0001). Conclusions: The wearing of elastic compression stockings on the lower legs is objectively effective for improving leg edema in pregnant women.

Physiological parameters and the use of compression stockings in individuals with spinal cord injuries: a scoping review.

Scoping review. To summarize information on the physiological effects of compression stockings (CS) in individuals with spinal cord injuries (SCI) and suggest areas for future research. We asked, "What are the physiological effects of CS use in individuals with SCI?" Original studies of patients with SCI regardless of sex and age that focused on SCI and CS were included. Five biomedical databases were searched. Studies were selected by three researchers in two stages, starting with an abstract and title screening and continuing with a full text review for application of the inclusion and exclusion criteria. A narrative synthesis was then performed. An initial search yielded 283 titles, of which five met the inclusion criteria and were subjected to the full text review. Among them, there were 78 individuals with SCI. The studies found that the use of CS at rest reduced deep vein thrombosis (DVT) and vascular capacitance but increased systolic blood pressure and norepinephrine level., three studies tested the use of CS During exercise; one found that time of the last lap in a standard court test was negatively affected; however, the greatest benefits were observed after exercises, such as reduced blood lactate level, improved autonomic function, and increased blood flow to the upper limbs. We conclude that future research should examine the physiological effects and relationship of CS with: (a) pharmacological interventions, (b) body position changes, (c) physical fitness level, (d) wheelchair use duration, (e) exercise-induced thermal stress, (f) thermal stress mitigation, and (g) edema reduction.

Compression Stockings Improve Cardiac Output and Cerebral Blood Flow during Tilt Testing in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Patients: A Randomized Crossover Trial.

Background and Objectives: Orthostatic intolerance (OI) is a clinical condition in which symptoms worsen upon assuming and maintaining upright posture and are ameliorated by recumbency. OI has a high prevalence in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Limited data are available to guide the treatment of OI in ME/CFS patients. We and others have previously described patient-reported subjective improvement in symptoms using compression stockings. We hypothesized that these subjective reports would be accompanied by objective hemodynamic improvements. Materials and Methods: We performed a randomized crossover trial in 16 ME/CFS patients. Each underwent two 15-min head-up tilt table tests, one with and one without wearing knee-high compression stockings that provided 20–25 mm Hg compression. The order of the tests was randomized. We measured heart rate and blood pressure as well as cardiac output and cerebral blood flow (CBF) using extracranial Doppler of the internal carotid and vertebral arteries. Results: There were no differences in supine measurements between the 2 baseline measurements. There were no differences in heart rate and blood pressure at either end-tilt testing period. Compared to the test with the stockings off, the mean percentage reduction in cardiac output during the test with compression stockings on was lower, 15 (4)% versus 27 (6)% (p < 0.0001), as was the mean percentage CBF reduction, 14 (4)% versus 25 (5)% (p < 0.0001). Conclusion: In ME/CFS patients with orthostatic intolerance symptoms, cardiac output and CBF are significantly reduced during a tilt test. These abnormalities were present without demonstrable heart rate and blood pressure changes and were ameliorated by the use of compression stockings.

Venous thromboembolism prophylaxis and related outcomes in patients with traumatic brain injury and prolonged intensive care unit stay

Objective: Traumatic brain injury (TBI) patients with prolonged intensive care unit (ICU) stay are at risk of secondary intracranial haemorrhage (ICH) and venous thromboembolism (VTE). We aimed to study VTE prophylaxis, secondary ICH, and VTE prevalence and outcomes in this population. Design: Retrospective observational study. Setting: Level 1 trauma centre ICU. Patients: One hundred TBI patients receiving prolonged ICU treatment (≥ 7 days). Interventions: We collected data from medical records, pathology and radiology systems, and hospital and ICU admission databases. We analysed patient characteristics, interventions, episodes and types of secondary ICH and VTE, and timing and dosage of VTE prophylaxis. Results: Data from the 100 patients in our study showed that early use of compression stockings and pneumatic calf compression was common (75% and 91% in the first 3 days, respectively). VTE chemoprophylaxis, however, was only used in 14% of patients by Day 3 and > 50% by Day 10. We observed VTE in 12 patients (10 as pulmonary embolism), essentially all after Day 6. Radiologically confirmed secondary ICH occurred in 43% of patients despite normal coagulation. However, 72% of ICH events (42/58) were radiologically mild, and the median time of onset of ICH was Day 1, when only 3% of patients were on chemical prophylaxis. Moreover, 82% of secondary ICH events (48/58) occurred in the first 3 days, with no severe ICH thereafter. Conclusions: In TBI patients receiving prolonged ICU treatment, early chemical VTE prophylaxis was uncommon. Early secondary ICH was common and mostly radiologically mild, whereas later secondary ICH was essentially absent. In contrast, early VTE was essentially absent, whereas later VTE was relatively common. Earlier chemical VTE prophylaxis and/or ultrasound screening in this population appears logical.

Postoperative morbidity differences between proximal and distal knee saphenous harvesting in coronary artery bypass graft surgery

Objectives. Coronary artery bypass grafting (CABG) is the most common procedure in cardiac surgery and the great saphenous vein (GSV) are the preferred conduits. The effects of saphenous vein incision (SVI) harvesting site choice on SVI wound complications, pretibial edema, and the need for compression stockings were evaluated retrospectively in patients undergoing CABG surgery. Materials and Methods. A total of 1900 patients operated for CABG between 2003 and 2021 in our clinic were included in this study, with GSV harvest performed at below-knee level (Group-A, n:841) and above-knee level (Group-B, n:1059). SVI was made 2 cm superior and 1 cm anterior to the medial malleolus in group-A; and 3 cm superior to medial epicondyle, extending to 3 cm inferior to the inguinal ligament in group-B. Examination for edema was made with 4-5 seconds of thumb pressure at the ankle level, then the depth of the pit was measured. Results. Ankle edema (Group-A n:132, Group-B n:25), the use of compression stockings (Group-A n:97, Group-B n:13), and paresthesia (Group-A n:51, Group-B n:10) were different between the two groups and the differences were statistically significant. However, prolonged wound healing (Group-A n:11, Group-B n:38), superficial wound infection (Group-A n:6, Group-B n:11), hematoma (Group-A n:4, Group-B n:9), and lymphorrhea (Group-A n:4, Group-B n:7) incidences were not statistically different between the two groups. Conclusions. Among patients with GSV extracted using the open conventional surgery technique, pretibial edema, paresthesia, and compression stocking use were observed less frequently in patients with preoperative doppler-ultrasonography evaluation and above-knee saphenous harvest.

INFLUENCE OF THE USE OF COMPRESSION STOCKINGS ON PHYSIOLOGICAL, PERCEPTUAL AND AFFECTIVE RESPONSES DURING THE RUNNING

This study aimed to compare the influence of wearing compression stockings on physiological, perceptual, and affective responses during the running. Ten recreational runners (31.5 ± 9.7 years) participated in this study. All subjects completed three visits to the lab: (a) familiarization and incremental test until exhaustion (b) two exercise sessions conducted on different days. Each session involved the same exercise protocol (20 min continuously at an intensity of 80% of the maximum treadmill speed achieved in the incremental test until exhaustion), with or without the use of compression stockings. The Felt Arousal Scale (FAS), Feeling Scale (FS), Rating of Perceived Exertion (RPE), oxygen consumption (VO2), and heart rate (HR) were recorded during each experimental session. Results showed no differences between the conditions of physiological (% VO2máx: 88.1 ± 8.3 vs 87.1 ± 11.32; % HR: 91.8 ± 2.8 vs 90.8 ± 3.2), perceptual (RPE: 6.4 ± 1.2 vs 6.2 ± 1.4) and affective (FS: 0.35 ± 2.4 vs 0.37 ± 2.3; FAS: 4.3 ± 0.7 vs 4.3 ± 1.1) responses during each exercise session. These results indicated that the use of the compression stockings did not promote benefits for physiological or psychological responses while running.

69-Year Old Man With Dysphagia and Nasal Regurgitation

69-Year Old Man With Dysphagia and Nasal Regurgitation

Learning process and results in endoscopic saphenous vein harvesting technique

Background/Aim: Endoscopic saphenous vein graft harvesting (EVH) has been increasingly used in coronary bypass graft (CABG) surgery in recent years due to its cosmetic advantage and reduced morbidity. However, for the successful application of this technique, a learning process is required. In this study, we aimed to compare the results of the experience we obtained in the initial phase and later periods of the EVH technique. Methods: Forty patients who underwent elective CABG between July 2015 and April 2017 were included in this retrospective cohort study. The first 20 patients (Group 1) and the next 20 patients (Group 2), whose saphenous vein graft (SVG) was prepared with the EVH technique were compared. The length and preparation time of SVGs prepared with EVH, local findings such as hematoma, necrosis, wound infection, and healing, demographic data, comorbidity, intraoperative and postoperative data, postoperative intensive care and hospitalization times, cosmetic satisfaction and wearing compression stockings were recorded. Results: While the mean operation time was 201.4 (25.0) minutes in Group 1, it was 184.6 (17.1) minutes in Group 2 (P=0.018). There was no difference in the mean SVG lengths between the groups (P>0.05). While SVG preparation time was 75.3 (26.2) minutes in Group 1, it was 35.4 (6.0) minutes in Group 2 (P<0.001). The number of minor branch injuries in the SVG in Groups 1 and 2 were eight (40%), and two (10%), respectively, and all underwent primary repair (P<0.001). Mean length of hospital stay was similar between the groups (P=0.955). No hematoma, infection or necrosis requiring surgical intervention was observed in the extremity from which the SVG was taken. The use of compression stockings was longer in group 1 than in group 2 for the reduction or complete disappearance of edema (56.4 (23.3) vs 42.0 (19.4) days, P=0.040). No patient in any of the groups required rehospitalization due to infection at the saphenous vein incision site and incision healing problem. According to the satisfaction survey, cosmetic satisfaction was high in both groups (P=0.530). Conclusion: We think that after the completion of the learning process on twenty patients, the EVH technique can be used more widely, with much better results in terms of both patient cosmetic satisfaction and reducing morbidity.

Graduated compression stockings for the initial treatment of varicose veins in people without venous ulceration.

Graduated compression stockings for the initial treatment of varicose veins in people without venous ulceration.

Pressure Injuries Related to the Use of Compression Stockings in Pediatric Surgical Patients

Abstract Mechanical compression devices such as compression stockings assist in the treatment and prevention of venous thromboembolism for nonambulatory postoperative patients. Risk factors in pediatric surgical patients increase their likelihood of developing a venous thromboembolism. This article describes an adolescent patient who developed pressure injuries from prolonged compression stocking use. Although other pressure injury prevention techniques were completed by nursing, the lack of knowledge regarding the risk of pressure injuries from compression stockings resulted in a poor outcome. As a result of this event, practice changes were implemented on the pediatric surgical unit to prevent reoccurrence. The practice changes included removal of compression stockings once per shift to assess extremities, daily replacement of new stockings, and utilization of sequential compression devices as the preferred mechanical compression method. Further research is needed for compression stocking use in the pediatric and adolescent population to provide best practice implications for nursing.

Compliance with the use of Compression Stockings, Experience from a Tertiary Center in Oman

Objectives: Compression stockings (CSs) are effective in the treatment of chronic venous and lymphatic diseases. Noncompliance with wearing them remains a hindrance to good results. This study aims to quantify the issue of noncompliance and to identify the reasons behind it. Methods: Over a period of 6 months, a set of questionnaire to assess the compliance to CSs was conducted on patients seen during their follow-up visits and of whom CSs were prescribed previously. Results: A total of 50 patients were recruited in this study. Females formed the majority of participants (76%), with a mean age of 42 years. The body mass index of our participants ranged between normal (18%), overweight (52%), and obese (30%). Most (78%) of our patients used CSs, while 22% did not. Duration of use ranged as follows: 40% of the patients used them for &lt;2 weeks, 26% used them for 2–8 weeks, while 30% used them for &gt;8 weeks. 71% of our patients encountered difficulty in finding appropriate CSs. Conclusions: Noncompliance with CSs is a true challenge. The reasons behind it start from difficulty in finding appropriate size/quality, to patient-related characteristics. These need to be frequently assessed by the prescribing doctor and addressed.

Cotton Balls and Socks—A Dangerous Combination: Foot Drop Related to Compression Stocking Use

Foot drop, from spinal or peripheral nerve disorder, affects gait and can contribute to falls. One of its more frequently identified etiologies is common peroneal nerve compression, often near the fibular head or neck, where the nerve is anatomically more superficial. The following Case illustrates an unusual example of unilateral foot drop that developed as the result of compression stocking use.

Lower Limb Compression Socks with Biomechanical Concepts

The use of compression stockings is increasingly widespread in sports as a post-exercise recovery system or to increase performance...