Wearing Compression Stockings Research Articles

Improving Adherence to Wearing Compression Stockings for Chronic Venous Insufficiency and Venous Leg Ulcers: A Scoping Review

PurposePatient adherence to wearing compression stockings in the management of chronic venous insufficiency (CVI) and venous leg ulcers (VLUs) is low. Poor adherence with compression stockings contributes to recurrence and impaired healing of VLUs. As such, the purpose of this review was to report on the scientific evidence related to adherence and explore modifiable factors which impact adherence with compression stockings.MethodsA systematic search was conducted from inception to 31 October 2019. Following the PRISMA-ScR Checklist, PubMed, Medline, CINAHL, Cochrane, Embase, OT Seeker and Web of Science were explored using search terms: compression/compression stocking/compression garment/compression sock/stockings/garments and adherence/compliance/concordance.ResultsWe identified 2613 papers of which 125 full text papers were assessed for eligibility and 69 met inclusion criteria. Papers were grouped and charted by concepts relevant to the research questions and narratively synthesized. Several dominant themes emerged, and a conceptual framework was developed incorporating modifiable variables, adherence itself, and outcomes related to adherence. Specifically considering interventions to improve adherence, only five of 14 randomized controlled trials were able to demonstrate improvements in adherence through unidimensional approaches. All nine of the case studies/series demonstrated a positive impact on adherence, eight of which described a personalized multidimensional approach. A lack of consensus around defining, measuring, and quantifying adherence with compression stockings was identified, resulting in wide variation in reported adherence rates.ConclusionInconsistency in the definition and measurement of adherence limits meaningful interpretation of the literature. No individual intervention has consistently demonstrated improved adherence. Multidimensional interventions show promise but require further investigation with high-quality trials. Improving adherence appears to improve health outcomes in VLU /CVI populations but there is a lack of information directly linking improved adherence with cost outcomes.Trial RegistrationOpen Science Framework: ACTRN12620000544976p.

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.

Compression stockings for preventing deep vein thrombosis in airline passengers.

Air travel might increase the risk of deep vein thrombosis (DVT). It has been suggested that wearing compression stockings might reduce this risk. This is an update of the review first published in 2006. To assess the effects of wearing compression stockings versus not wearing them for preventing DVT in people travelling on flights lasting at least four hours. The Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register, CENTRAL, MEDLINE, Embase, CINAHL and AMED databases and World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov trials registers to 1 April 2020. We also checked the bibliographies of relevant studies and reviews identified by the search to check for any additional trials. Randomised trials of compression stockings versus no stockings in passengers on flights lasting at least four hours. Trials in which passengers wore a stocking on one leg but not the other, or those comparing stockings and another intervention were also eligible. Two review authors independently selected trials for inclusion and extracted data. We sought additional information from trialists where necessary. One new study that fulfilled the inclusion criteria was identified for this update. Twelve randomised trials (n = 2918) were included in this review: ten (n = 2833) compared wearing graduated compression stockings on both legs versus not wearing them; one trial (n = 50) compared wearing graduated compression tights versus not wearing them; and one trial (n = 35) compared wearing a graduated compression stocking on one leg for the outbound flight and on the other leg on the return flight. Eight trials included people judged to be at low or medium risk of developing DVT (n = 1598) and two included high-risk participants (n = 1273). All flights had a duration of more than five hours. Fifty of 2637 participants with follow-up data available in the trials of wearing compression stockings on both legs had a symptomless DVT; three wore stockings, 47 did not (odds ratio (OR) 0.10, 95% confidence interval (CI) 0.04 to 0.25, P < 0.001; high-certainty evidence). There were no symptomless DVTs in three trials. Sixteen of 1804 people developed superficial vein thrombosis, four wore stockings, 12 did not (OR 0.45, 95% CI 0.18 to 1.13, P = 0.09; moderate-certainty evidence). No deaths, pulmonary emboli or symptomatic DVTs were reported. Wearing stockings had a significant impact in reducing oedema (mean difference (MD) -4.72, 95% CI -4.91 to -4.52; based on six trials; low-certainty evidence). A further three trials showed reduced oedema in the stockings group but could not be included in the meta-analysis as they used different methods to measure oedema. No significant adverse effects were reported. There is high-certainty evidence that airline passengers similar to those in this review can expect a substantial reduction in the incidence of symptomless DVT and low-certainty evidence that leg oedema is reduced if they wear compression stockings. The certainty of the evidence was limited by the way that oedema was measured. There is moderate-certainty evidence that superficial vein thrombosis may be reduced if passengers wear compression stockings. We cannot assess the effect of wearing stockings on death, pulmonary embolism or symptomatic DVT because no such events occurred in these trials. Randomised trials to assess these outcomes would need to include a very large number of people.

Randomized Controlled Trial of Compression After Endovenous Thermal Ablation of Varicose Veins (COMETA Trial)

Background The 21st century has witnessed a rise in the use of endovenous thermal ablation. Being highly clinically and cost-effective and improving the quality of life of patients, they are now considered to be the gold-standard treatment for varicose veins. Post-intervention management, especially in terms of postoperative compression, however, remains unclear. As a result, a randomized study was undertaken to investigate the effects of wearing compression stockings after varicose vein treatment. Method Patients with saphenous vein reflux undergoing treatment with endothermal ablation (with or without concurrent phlebectomies) were randomized to receive either 7 days of compression stockings or no stockings. The primary outcome measure for this study was the pain score over the first 10 postoperative days. The pain scores, clinical score, time to return to normal activities, and ecchymosis were assessed. Patients were followed-up at 2 weeks and 6 months post-ablation. Results In total, 206 patients were randomized, 49% of them to the compression group. The mean age was 49.7 (±16) years and approximately 51% of the population was male. The median pain score in the compression group using a visual analog scale was significantly lower on days 2-5, compared to the no compression group. Those having concurrent phlebectomies and compression stockings also had significantly better pain scores on days 1-3, day 5, and day 7. Improvement in the median venous clinical severity score was noted at 6-month follow-up, but this was not significant. No difference in the generic- or disease-specific quality of life was observed and the time to return to activities was similar. There were no differences in the degree of ecchymosis between the 2 groups and both groups had similar occlusion rates. Conclusions These results indicate that wearing compression stockings after endothermal ablation is advantageous in the first few days after treatment and is especially beneficial for those having concurrent phlebectomies.

고정자세 직업의 중년여성에 대한 압박 스타킹의 착용이 정적 및 동적 안정성에 미치는 효과

고정자세 직업의 중년여성에 대한 압박 스타킹의 착용이 정적 및 동적 안정성에 미치는 효과

Editor's Choice - Role of Compression After Radiofrequency Ablation of Varicose Veins: A Randomised Controlled Trial

This randomized controlled trial of 100 consecutive patients with symptomatic venous insufficiency underwent RFA for mostly C3 to C4 disease. Randomization was done at the end of the procedures, 80% had RFA of saphenous veins, with patients opening a sealed envelope. Patients who wore compression stockings following radiofrequency ablation (RFA) did not have better outcomes than those who did not wear compression. Class 2 (23-32 mm Hg) compression was applied to the compression cohort who wore the hose for 2 weeks. Multiple satisfaction questionnaires were completed by all participants. At 12 weeks, there were no differences in occlusion rates (98% both groups), mean Aberdeen Varicose Vein Severity Scores and Revised Venous Clinical Severity Scores, satisfaction and pain scores, and deep venous thrombosis events. Although this relatively small clinical trial showed that there was no added benefit to compression following RFA for venous insufficiency, it is interesting that compression was only worn for 2 weeks. It is good to know that patients who cannot tolerate compression or in whom lighter compression is used will not have decreased occlusion rates as a result. But we also know that recanalization is not always accompanied by recurrent symptoms. My take home message is not to decline treatment to a patient who cannot tolerate long-term compression.

Chronic venous insufficiency and graduated compression stockings: analysis of public health system patients' adherence to treatment.

BackgroundChronic venous insufficiency (CVI) is a pathology of great importance due to its high worldwide prevalence, affecting up to 80% of the population. Its incidence increases with age and is more frequent in females. One of the most important treatment options is compression therapy and the main method employed is wearing graduated compression stockings, which is considered the basic treatment for CVI regardless of the patient’s clinical classification. In clinical practice, treatment outcomes are impaired by patients not wearing the stockings properly.ObjectivesTo analyze the rate of adherence to wearing graduated compression stockings and to understand the problem of treatment non-adherence.MethodsCross-sectional observational study conducted from June 2017 to January 2019, based on administration of questionnaires to patients at a SUS vascular surgery clinic at a teaching hospital, in Curitiba, PR, Brazil. Data were analyzed using the IBM SPSS Statistics v.20.0 computer program.Results240 patients were analyzed. Mean age was 57.5 ± 12.9 (22 - 86) and 84.2% of the sample were female. 106 of the 240 patients analyzed (44.2%) were non-adherent with wearing compression stockings. Reasons for not wearing the stockings were: financial; pain; ignorance of the need to wear them; heat; and others.ConclusionsThe adherence rate observed in the present study was 55.8% and the most prevalent reason for not wearing stockings was financial.

Getting Ready for Wound Certification: Assessing and Managing Lower Extremity Venous Disease.

Getting Ready for Wound Certification: Assessing and Managing Lower Extremity Venous Disease.

Occupational leg edema-use of compression stockings.

To analyze the use of compression stockings to avoid the formation of occupational edema of the lower limbs in jobs with prolonged orthostatism. We carried out a review of the articles published in PubMed, from the 1st of January 2008 to 31st of December 2018 using the term “Occupational Leg Swelling”. Only articles that met the following criteria were selected: prospective, observational and experimental retrospectives articles written in Portuguese or English. The research resulted in 23 articles. After reading the titles and abstracts and applying the inclusion and exclusion criteria, 5 were selected. Prolonged orthostatism is considered a risk factor for the development of chronic venous disease. The use of compression stockings reduces the occupational edema of the lower limbs. Professionals exposed to prolonged orthostatism during their work activity have a higher risk of developing lower limb edema; Despite few studies demonstrated the effectiveness of wearing compression stockings to prevent occupational edema of the lower limbs, they have showed benefit in reducing edema as well as associated symptoms. The use of compression stockings should therefore be recommended to all professionals at increased risk for occupational edema of the lower limbs.

Effects of Wearing Compression Stockings on Exercise Performance and Associated Indicators: A Systematic Review.

This systematic review investigated the effects of wearing below-knee compression stockings (CS) on exercise performance (or sports activity) and associated physiological and perceived indicators. We searched articles on PubMed using the following terms: “graduated compression stockings”; “compression stockings”; “graduated compression socks”; “compression socks” combined with “performance”, “athletes”, “exercise”, “exercise performance”, “fatigue”, “sports” and “recovery”, resulting in 1067 papers. After checking for inclusion criteria (e.g., original studies, healthy subjects, performance analysis), 21 studies were selected and analyzed. We conclude that wearing CS during exercise improved performance in a small number of studies. However, wearing CS could benefit muscle function indicators and perceived muscle soreness during the recovery period. Future research should investigate the chronic effect of CS on Sports Medicine and athletic performance.

Randomized Controlled Trial of Compression After Endovenous Thermal Ablation of Varicose Veins (COMETA Trial).

The 21st century has witnessed a rise in the use of endovenous thermal ablation. Being highly clinically and cost-effective and improving the quality of life of patients, they are now considered to be the "gold-standard" treatment for varicose veins. Post-intervention management, especially in terms of postoperative compression, however, remains unclear. As a result, a randomized study was undertaken to investigate the effects of wearing compression stockings after varicose vein treatment. Patients with saphenous vein reflux undergoing treatment with endothermal ablation (with or without concurrent phlebectomies) were randomized to receive either 7 days of compression stockings or no stockings. The primary outcome measure for this study was the pain score over the first 10 postoperative days. The pain scores, clinical score, time to return to normal activities, and ecchymosis were assessed. Patients were followed-up at 2 weeks and 6 months post-ablation. In total, 206 patients were randomized, 49% of them to the compression group. The mean age was 49.7 (±16) years and approximately 51% of the population was male. The median pain score in the compression group using a visual analog scale was significantly lower on days 2-5, compared to the no compression group. Those having concurrent phlebectomies and compression stockings also had significantly better pain scores on days 1-3, day 5, and day 7. Improvement in the median venous clinical severity score was noted at 6-month follow-up, but this was not significant. No difference in the generic- or disease-specific quality of life was observed and the time to return to activities was similar. There were no differences in the degree of ecchymosis between the 2 groups and both groups had similar occlusion rates. These results indicate that wearing compression stockings after endothermal ablation is advantageous in the first few days after treatment and is especially beneficial for those having concurrent phlebectomies.

Incidence and Prevention of Deep Vein Thrombosis in Patients with Popliteal Vein Aneurysm

Introduction: Venous popliteal aneurysms are associated with high risk for deep vein thrombosis (DVT) and pulmonary embolism (PE). The goal of this study was to report the incidence and prevention options of DVT in patients with popliteal vein aneurysm. Methods: All patients between 06/1993 and 03/2019 with diagnosed popliteal venous aneurysm were enrolled in this study and analyzed retrospectively. Data were collected prospectively in an institutional database (M1, CompuGroup Medical) throughout the observation period by trained staff. The patients related variables were documented in a standardized manner. They received regular surveillance alone or treatment. Patients were offered aneurysm resection or lifelong anticoagulation if they had aneurysm size twice of normal vein diameter. Compression stockings were recommended in all cases. Clinical exam and duplex ultrasound were performed 3-6 months after operation or primary diagnosis and annually thereafter. In case of incompliance of wearing compression stockings, patients received instructions of the importance of compression and help for dressing them. Results: In a total of 58 patients 60 popliteal vein aneurysms (aneurysm size mean 20.3 mm) were diagnosed. Two patients had popliteal vein aneurysm on both legs (mean 1.5 mm). 33 patients had aneurysm size >20 mm in diameter. They had a significantly higher incidence of turbulent flow in duplex sonographic examination with higher risk for development of DVT (7/33; p=.006). Out of them, 30/33 (91%) preferred aneurysm resection, while 3/33 (9%) patients were treated with lifelong anticoagulation and compression. Patients with aneurysm size < 20 mm were treated with compression stockings alone. No DVT occured after treatment or in patients with small popliteal vein aneurysm size. Mean follow up was 39.5±8.7 months. Conclusion: Patients with large popliteal venous aneurysms experience DVT more frequently. Therefore, popliteal vein aneurysms >20 mm should be considered for surgical treatment or lifelong anticoagulation, depending on patient's preference. In patients with small aneurysm size regular control and compression stockings in risk situations are adequate. Disclosure: Nothing to disclose

The effects of compression stockings on the energetics and biomechanics during walking.

The purpose of this study was to explore how compression stockings affect the energetics and biomechanics during walking. Sixteen male adults participated in this study. Participants completed walking trials on the treadmill and force plates, wearing compression stockings (CS) or nothing as a control condition (CON). The data obtained included metabolic rate, muscle activation, step frequency and step length as well as their variability, joint kinematics and joint kinetics. The effect of compression stockings on metabolic rate was trivial (CS: 3.81 ± 0.44Wkg-1, CON: 3.83 ± 0.46Wkg-1, p = 0.84, d = 0.05). Activation of calf muscles, step frequency and step length as well as their variability, joint range of motion and joint powers did not show a significant difference between conditions (p = 0.09-0.90, d = 0.01-0.34). The peak knee extension moment during the early stance phase had a tendency to increase (CS: 0.57 ± 0.27Nmkg-1, CON: 0.51 ± 0.28Nmkg-1, p = 0.05, d = 0.19) while the peak knee flexion moment during the late swing phase had a tendency to decrease (CS: 0.16 ± 0.10Nmkg-1, CON: 0.19 ± 0.12Nmkg-1, p = 0.10, d = 0.21). The peak ankle dorsiflexion moment during the early stance phase significantly increased (CS: 0.11 ± 0.06Nmkg-1, CON: 0.08 ± 0.05Nmkg-1, p = 0.02, d = 0.58) while the peak ankle plantar flexion moment during the late swing phase significantly decreased (CS: 1.41 ± 0.12Nmkg-1, CON: 1.47 ± 0.14Nmkg-1, p = 0.02, d = 0.45). Compression stockings have a limited effect on improving energetics of walking, but they may play a role in improving biomechanics by altering the relative contribution of knee and ankle moments to propulsion.

Correlation between patency and clinical improvement after lymphaticovenous anastomosis (LVA) in breast cancer-related lymphedema: 12-month follow-up

PurposeBreast cancer-related lymphedema (BCRL) is caused by an interruption of the lymphatic system after breast cancer treatment. Lymphaticovenous anastomosis (LVA), by which one or more patent lymphatic collecting vessels are connected to subcutaneous veins, shows promising results. Postoperatively, the patency of these anastomosis can be evaluated; however, little is known concerning the long-term patency after LVA in patients with BCRL. The aim of this study was to analyse the long-term patency, quality of life (QoL) and arm circumference after LVA, and to explore differences between patent and non-patent anastomosis and its correlation with clinical improvement.MethodsTwenty-five patients underwent indocyanine green (ICG) lymphography, lymph ICF-questionnaire, and arm circumference measurement preoperatively and 12 months after the LVA procedure.ResultsSeventy-six percent of the patients showed at least one patent anastomosis after 12 months. Quality of life according to the Lymph-ICF increased significantly (p < 0.000); however, arm circumference showed no significant decrease. Sixty-five percent discontinued wearing compression stockings. The patent anastomosis group, compared with the non-patent anastomosis group showed, without significance, more improvement in QoL, arm circumference, and discontinuation of compression stockings, as well as a lower rate of infections both pre- and postoperatively, a shorter duration of lymphedema preoperatively, and a higher rate of early lymphedema and ICG stage.ConclusionsLVA showed an acceptable patency and positive correlation between a patent anastomosis and clinical improvement after 12 months. Further research with a larger study population is required to determine whether outcomes or patient characteristics significantly correlate with a patent anastomosis after LVA operation.

Compression Stockings Suppressed Reduced Muscle Blood Volume and Oxygenation Levels Induced by Persistent Sitting

This study quantitatively analyzed the effects of 3 h of constant sitting on skeletal muscle oxygenation in the lower extremities, using near-infrared time-resolved spectroscopy (NIRTRS). The effects of compression stockings were also evaluated. Eleven healthy men (age, 30.0 ± 6.7 years) maintained their knee joints at 90° flexion during 3 h of constant sitting and wore a compression stocking on either the right or left leg. The side the stocking was worn was chosen randomly. Subsequently, leg circumference and extracellular water were measured. After 3 h of sitting, both factors increased significantly in uncompressed limbs. Furthermore, intracellular water and muscle oxygenation had significantly decreased. In contrast, extracellular water had not increased in the limbs wearing compression stockings. Furthermore, the increased circumference of compressed limbs was significantly smaller than that of uncompressed limbs. Decreases in oxygenated hemoglobin and total hemoglobin were significantly smaller in compressed limbs than in uncompressed limbs (oxy-Hb; p = 0.021, total-Hb; p = 0.013). Three hours of sitting resulted in decreased intracellular water and increased extracellular water in the lower extremities, leading to reduced blood volume and oxygenation levels in skeletal muscle. Compression stockings successfully suppressed these negative effects.

Impact of compression stockings on leg swelling after arthroscopy \u2013 a prospective randomised pilot study

BackgroundPost-operative limb swelling may negatively affect the outcome of arthroscopic surgery and prolong rehabilitation. The aim of this pilot study was to evaluate the effect of compression stockings versus no compression on post-operative swelling and pain in the early post-operative phase.MethodsA single-centre, randomised controlled trial was performed. Patients who underwent minor knee arthroscopy were randomised to wear class II compression stockings (23-32 mmHg) (CS) or no compression stockings (NCS) immediately post-operatively for ten days. All patients received low molecular weight heparin (LMWH) at prophylactic dosage. The primary outcome variable was post-operative swelling of the limb, quantified by using an optical 3D measurement system (Bodytronic© 600). Pain was rated on a visual analogue scale (VAS). From a total of 76 patients assessed, 19 patients were eligible for final analysis. The trial followed the CONSORT criteria, was registered at clinicaltrial.gov and approved by the local ethics committee.ResultsThe circumference at the middle thigh (cF) was significantly different between groups at day 10 (p = 0.032; circumference − 1.35 ± 2.15% (CS) and + 0.79 ± 3.71% (NCS)). Significant differences were also noted around the knee (cD) at day 10 (p = 0.026) and a significant trend at cD and at the mid lower leg (cB1) at day 4. The volume of the thigh was also different with marked difference between days 1 and 4 between the two groups (p = 0.021; volume + 0.54 ± 2.03% (CS) and + 4.17 ± 4.67 (NCS)). Pain was lower in compression group (not statistically significant).ConclusionsPost-operative limb swelling can be reduced significantly by wearing compression stockings in the early post-operative phase when compared to not wearing stockings. This may improve the rehabilitation process after arthroscopic surgery. The optimal duration of compression therapy seems to be between three and ten days.Trial registrationclinicaltrials.gov (NCT02096562, date of registration 11.11.2013).

Preventing recurrent cellulitis

Cellulitis is a painful skin infection that occurs most commonly in the lower leg. Around a third of people with cellulitis have repeat episodes, meaning they have it more than once. The only treatment shown to lower the risk of repeat episodes is long‐term antibiotics. Other possible ways to prevent repeat episodes include greater foot hygiene, applying cream to feet daily, exercise and wearing compression stockings. This study, from the U.K., aimed to find out people's views about cellulitis and different ways of preventing repeat episodes. Adults (aged 18 or over) who had had cellulitis were invited through doctors’ surgeries, hospitals and local advertising to complete a survey, take part in an interview, or both. In total, 240 people completed a survey and 30 people took part in face‐to‐face interviews. The authors found that people in the study had wide‐ranging beliefs about what can cause cellulitis and were often unaware of the possibility of repeat episodes or how to prevent future episodes. Greater foot hygiene, applying cream to feet daily and exercise were more popular potential strategies for preventing repeat episodes than compression stockings or long‐term antibiotics. People had concerns about long‐term oral antibiotics for a variety of reasons, particularly those who had experienced only one episode of cellulitis. People were keen to find out about possible ways to prevent repeat episodes of cellulitis. More research is needed to find out how well the different ways actually prevent repeat episodes and what may fit best into people's daily lives.

The effect of compression stocking on leg edema and discomfort during a 3-hour flight: A randomized controlled trial

BackgroundCompression stockings reduce the risk of thromboembolic complications, leg edema, and edema-related pain and discomfort during long-haul flights. The aim of this study was to assess if compression stockings reduce leg edema, pain, and discomfort during a three-hour flight. MethodsThis randomized controlled trial had a paired design as participants were randomized to wear a compression stocking on one leg during a three-hour flight with the other leg acting as control. Eligibility criteria were adults aged 18–60 years living in Denmark without medical indication for wearing compression stockings during flights. The primary outcome was the change in difference of ankle circumference between legs with and without compression stocking pre- and post-flight. Secondary outcomes were changes in difference of calf circumference, pain, and discomfort pre- and post-flight. All outcomes were self-reported with measurements and questionnaires. ResultsA total of 34 participants, median age 31 years (range 25–54), were randomized with complete follow-up. Difference in ankle circumference was median 5 mm larger post-flight compared with pre-flight (interquartile range (IQR) = 0–9, p = .001) and the corresponding change in calf circumference difference was median 5 mm (IQR = 1–12, p < .001). Ankle- and calf circumferences decreased in the leg wearing compression stocking and increased in the other leg. There was no change in difference of pain and discomfort and no adverse events. ConclusionCompression stockings reduced edema formation in young healthy passengers during a three-hour flight. Passengers experiencing edema-related discomfort during short-haul flights may benefit from wearing compression stockings during air travel.Trial registration: clinicaltrials.gov: NCT03546725.

Do You Aware of Hypotension

If want to become a healthy person, need to do many changes in day-to-day life. Same like in human body if the heart works without any difficulties, it maintains a healthy body. One of the Alteration in blood pressure is Hypotension .it is nothing but the blood pressure that is lower than 90/60mmhg. It has four types that are orthostatic or postural hypotension, postprandial hypotension, neurally mediated hypotension and severe hypotension. Each one different from others. General causes for hypotension are:1. Heart rate problem [too fast heart rate or too slow], 2. A heart muscle or pump problem[myocardial infarction, cardiomyopathy], 3.A volume problem [hemorrhage, GI fluid loss, renal injury, large volume fluid loss, prolonged intake of alcohol, posture changes, stand or sit after heavy meal, a faulty brain signals, shock etc]. General measures to treat or prevent hypotension includes increase salt intake, foot end elevation, take plenty of oral fluids, avoid alcohol, do exercises regularly, avoid bending at waist, wear compression stockings, tale small and frequent meals, take vitamin supplements etc.