Compliance with compression stockings in patients with chronic venous disorders

2011 ◽  
Vol 26 (8) ◽  
pp. 353-360 ◽  
Author(s):  
D Ziaja ◽  
P Kocełak ◽  
J Chudek ◽  
K Ziaja
Keyword(s):  
Varicose Veins ◽  
Clinical Stage ◽  
Compression Therapy ◽  
Compression Stocking ◽  
Compression Stockings ◽  
Vein Thrombosis ◽  
Cosmetic Reason ◽  
The Common ◽  
Large Survey ◽  
Venous Disorders

Objective The aim of this large survey was to evaluate non-compliance with compression stockings in chronic venous disorder (CVD) patients. Method A total of 16,770 CVD patients participated in this study. Results Compression stockings were used by 25.6% of CVD patients and 46.6% of the patients were never prescribed compression therapy. Compression stocking use was found to increase with the clinical stage of CVD. The percentage of patients using compression stockings during control visits increased to 37.4%. Furthermore, 5.3% of the patients coming to control visits discontinued the use of compression stockings owing to high cost, sweating, itching, cosmetic reason, oedema exacerbation, exudation lesions of lower legs and application difficulty. Past episodes of vein thrombosis (OR = 0.80), of stroke (OR = 0.28) and of varicose veins surgery (OR = 0.28) were decreasing, while the management by a general practitioner was increasing the risk (OR = 1.36) of compression therapy cessation. Conclusion (1) Compression stockings are too rarely prescribed and often unaccepted at early stages of CVD; (2) The common reason for discontinuation of compression therapy is its high cost.

Primary varicose veins

Phlebologie ◽  
2010 ◽  
Vol 39 (03) ◽  
pp. 133-137
Author(s):  
H. Partsch
Keyword(s):  
Varicose Veins ◽  
Compression Therapy ◽  
Daily Practice ◽  
Clinical Severity ◽  
Compression Stockings ◽  
Primary Varicose Veins ◽  
The Cost ◽  
Convincing Data ◽  
Long Term Studies

SummaryBackground: Compression stockings are widely used in patients with varicose veins. Methods: Based on published literature three main points are discussed: 1. the rationale of compression therapy in primary varicose veins, 2. the prescription of compression stockings in daily practice, 3. studies required in the future. Results: The main objective of prescribing compression stockings for patients with varicose veins is to improve subjective leg complaints and to prevent swelling after sitting and standing. No convincing data are available concerning prevention of progression or of complications. In daily practice varicose veins are the most common indication to prescribe compression stockings. The compliance depends on the severity of the disorder and is rather poor in less severe stages. Long-term studies are needed to proof the cost-effectiveness of compression stockings concerning subjective symptoms and objective signs of varicose veins adjusted to their clinical severity. Conclusion: Compression stockings in primary varicose veins are able to improve leg complaints and to prevent swelling.

Varicose Veins: optimum compression after surgery and sclerotherapy

1990 ◽  
Vol 76 (2) ◽  
pp. 101-104
Author(s):  
P. J. Shouler ◽  
P. C. Runchman
Keyword(s):  
Surgical Treatment ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Compression Stocking ◽  
Compression Stockings ◽  
Varicose Vein Surgery ◽  
High Compression ◽  
Graduated Compression Stockings ◽  
Non Surgical Treatment

SummaryGraduated compression stockings are used in both surgical and non-surgical treatment of varicose veins. In a trial of high versus low compression stockings (40mmHg vs 15mmHg at ankle) after varicose vein surgery, both were equally effective in controlling bruising and thrombophlebitis, but low compression stockings proved to be more comfortable.In a further trial after sclerotherapy, high compression stockings alone produced comparable results to Elastocrepe® bandages with stockings. It is concluded that after varicose vein surgery low compression stockings provide adequate support for the leg and that after sclerotherapy, bandaging is not required if a high compression stocking is used.

Non-pharmacological treatment of lower extremity varicose veins in patients who are not classified for surgical treatment

2017 ◽  
Vol 2 (3) ◽  
pp. 111-120
Author(s):  
Zuzanna Radosz ◽  
Małgorzata Ptaszyńska
Keyword(s):  
Surgical Procedures ◽  
Lower Limb ◽  
Pharmacological Treatment ◽  
Varicose Veins ◽  
Compression Therapy ◽  
Interventional Treatment ◽  
Invasive Treatment ◽  
Class I Obesity ◽  
Vein Thrombosis ◽  
Deep Vein

The purpose of this study is to discuss non-pharmacological methods of lower limb varices treatment for patients not qualified for surgical procedures. These methods can be used by both nurses and patients. There are the following types of varices treatment: interventional treatment, compression therapy and other non-pharmacological methods. Surgery is a traditional method of treatment, however it is not suitable for lower limb arterial ischemia, deep vein patency, haemorrhagic diathesis, deep vein thrombosis, acute infectious disease, pregnancy and class I obesity (BMI>29). In the abovementioned cases the following types of non-invasive treatment are recommended: compression therapy and other such non-pharmacological methods as; limb elevation, diet, hardening of the arteries in the affected limb, proper footwear selection and physical activity. Despite the degree of severity of the condition and undertaken surgical procedures the preventive medical treatment should be considered in the therapy as it (the therapy) significantly affects the further development of varicose veins and the severity of ailments related to the disease. Results of a number of studies confirm the importance of the integrity between pharmacological and non-pharmacological treatment.

The Post-Thrombotic Syndrome

Hematology ◽  
2010 ◽  
Vol 2010 (1) ◽  
pp. 216-220 ◽  
Author(s):  
Susan R. Kahn
Keyword(s):  
Risk Factors ◽  
Anticoagulation Therapy ◽  
Compression Therapy ◽  
Secondary Prophylaxis ◽  
Compression Stockings ◽  
Elastic Compression ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Venous Ulcers ◽  
Risk Determinants

AbstractThe post-thrombotic syndrome (PTS) is an important chronic complication of deep vein thrombosis (DVT). The present review focuses on risk determinants of PTS after DVT and available means to prevent and treat PTS. More than one-third of patients with DVT will develop PTS, and 5% to 10% of patients develop severe PTS, which can manifest as venous ulcers. PTS has an adverse impact on quality of life as well as significant socioeconomic consequences. The main risk factors for PTS are persistent leg symptoms 1 month after acute DVT, anatomically extensive DVT, recurrent ipsilateral DVT, obesity, and older age. Subtherapeutic dosing of initial oral anticoagulation therapy for DVT treatment may also be linked to subsequent PTS. By preventing the initial DVT and DVT recurrence, primary and secondary prophylaxis of DVT will prevent cases of PTS. Daily use of elastic compression stockings for 2 years after proximal DVT appears to reduce the risk of PTS; however, uncertainty remains regarding optimal duration of use, optimal compression strength, and usefulness after distal DVT. The cornerstone of managing PTS is compression therapy, primarily using elastic compression stockings. Venoactive medications such as aescin and rutosides may provide short-term relief of PTS symptoms. Further studies to elucidate the pathophysiology of PTS, to identify clinical and biological risk factors, and to test new preventive and therapeutic approaches to PTS are needed.

Postoperative quality of life, satisfaction, and skin condition after varicose vein surgery

Phlebologie ◽  
2016 ◽  
Vol 45 (06) ◽  
pp. 363-369
Author(s):  
G. Bruning ◽  
A. Langenbruch ◽  
M. Augustin ◽  
W. Kath
Keyword(s):  
Quality Of Life ◽  
Varicose Veins ◽  
Skin Condition ◽  
Skin Care ◽  
Surgical Removal ◽  
Compression Stocking ◽  
Free Text ◽  
Compression Stockings ◽  
Skin Moisture

SummaryCompression is performed postoperatively with the intention of minimising side effects, such as bleeding and haematoma in the area of operation, as well as postoperative oedema and pain. Compression stocking manufacturing has incorporated the addition of skin care products into the yarn material in recent years. However, the benefits of these products remain controversial. In addition, the length of the compression stocking is disputed in terms of its effectiveness. This effectiveness was investigated in the present study.Before surgery, 160 patients with indication of surgical removal of varicose veins were randomly divided into four groups with different types of compression stockings in each case. In each group, 40 patients received a knee-length stocking (length A–D), thigh-length stocking (length A–G), knee-length stocking with Aloe vera or thigh-length stocking with AV. At time 0 (before surgery), one week and 8 weeks after surgery, skin moisture was measured as an objective parameter, quality of life was determined using the Freiburger questionnaire of quality of life in veinous disease (FLQA-vs), benefit to patients was evaluated using the patient benefit index (PBI-v) and further subjective parameters were investigated with a free-text questionnaire. After surgery, the extent of haematoma was determined using the point count method.After surgery, at both post-operative times, the FLQA-vs decreased significantly (corresponding to a better quality of life), and the PBI-v increased. In the group with Aloe, pruritus was significantly lower, comfort and skin moisture were increased, and skin condition was significantly improved. The extent of haematoma decreased regardless of the length of the stockings.A benefit of AV as a skin care additive was observed. This finding was objectively confirmed based on the skin moisture. The multifactorial quality of life was not affected by the skin care additive. Thigh-length compression stockings did not provide a measurable benefit.

Timing and duration of compression therapy after deep vein thrombosis

2014 ◽  
Vol 29 (1_suppl) ◽  
pp. 78-82 ◽  
Author(s):  
AC Bouman ◽  
AJ ten Cate-Hoek
Keyword(s):  
Deep Vein Thrombosis ◽  
Preventive Measure ◽  
Compression Therapy ◽  
Controlled Trials ◽  
Compression Stockings ◽  
Vein Thrombosis ◽  
Randomized Controlled ◽  
Optimal Duration ◽  
Deep Vein

After deep vein thrombosis (DVT) 20-50%, of patients develop post thrombotic syndrome (PTS). Up till now, there is no effective treatment for PTS and prevention is therefore of major importance. Compression therapy after DVT, with elastic compression stockings (ECS), is the only available preventive measure for PTS. However, the usefulness, timing, and duration of compression therapy are matters of debate. The effect of early compression on the long-term development of PTS is still unclear as studies performed so far have conflicting outcomes.16–19 The effectiveness of ECS therapy initiated in the sub-acute phase was assessed in three large randomized controlled trials. Kahn et al could not reproduce the large risk reduction found in the trials by Brandjes and Prandoni et al.20–22 Also for the optimal duration of ECS therapy, a certain conclusion has yet to be drawn. Therefore identification of patients who most likely will benefit from ECS therapy as well as the optimal ECS treatment strategy remain subjects for further study.

scholarly journals Short-term compression therapy in chronic vein disease without trophic disorders: possibilities of medical compression knitwear

2021 ◽  
Vol 18 (1) ◽  
pp. 40-46
Author(s):  
H. P. Manjikian ◽  
S. V. Chubchenko ◽  
D. A. Feodorov ◽  
A. G. Bagdasaryan ◽  
B. A. Danelyan ◽  
...  
Keyword(s):  
Adverse Events ◽  
Varicose Veins ◽  
Compression Therapy ◽  
Average Score ◽  
Compression Stockings ◽  
Short Term ◽  
Elastic Band ◽  
Conservative Strategy ◽  
Venous Interventions

Introduction. Medical compression stockings are one of the main methods in a conservative strategy for the treatment of chronic vein diseases as well as for adjuvant treatment after superficial venous interventions. however, compliance to this treatment is low.Objective. To evaluate patient satisfaction with medical compression knitwear therapy in a short-term follow-up.Materials and мethods. The study included 150 patients of both sexes aged 42 ± 8.3 years. Endovenous laser obliteration combined with mini-phlebectomy and/or sclerotherapy for varicose veins was performed. All patients after the surgery wore compression stockings of compression class 2 with a recommended wearing period of 14 days. At the control visit at the end of the follow-up period all patients were asked to complete a satisfaction survey with a specially prepared questionnaire including 7 questions.Results and discussion. No significant adverse events and complications related to either the invasive intervention or the compression therapy were observed during the follow-up period. There were no abnormalities such as compression sensations or changes in blood flow under the knitwear. The compression was totally adequate, with no areas of over- and/or under-compression. All respondents felt that the knitwear was well anchored to the leg and no slipping or twisting due to the wide elastic band with droplet silicone. In addition to all of the above, the patients noted that the knitwear offered to them in the study had good tactile properties: it was soft and pleasant to the skin. According to the survey, the average score for all questions was 9.5 (QR 8-10).Conclusion. Elastic compression is an effective and safe means of preventing adverse events, complications and pain in patients after superficial varicose veins surgery. Additional consumer properties of medical compression knitwear can significantly influence patients’ compliance and therefore the effectiveness of treatment.

Compression with 23 mmHg or 35 mmHg stockings after saphenous catheter foam sclerotherapy and phlebectomy of varicose veins: A randomized controlled study

2018 ◽  
Vol 34 (2) ◽  
pp. 98-106 ◽  
Author(s):  
Attilio Cavezzi ◽  
Giovanni Mosti ◽  
Roberto Colucci ◽  
Valentina Quinzi ◽  
Luca Bastiani ◽  
...  
Keyword(s):  
Varicose Veins ◽  
Controlled Study ◽  
Compression Stocking ◽  
Compression Stockings ◽  
Foam Sclerotherapy ◽  
Tissue Healing ◽  
Group A ◽  
Group B ◽  
Skin Healing ◽  
Single Blind

Objectives To compare two different medical compression stockings after varicose vein treatment. Patients and methods A randomized single-blind controlled study on two compression regimes after saphenous catheter foam sclerotherapy + phlebectomy was performed. After pads and 5 mmHg contention sock, 23 mmHg (group A, Struva 23®) or 35 mmHg (group B, Struva 35®) medical compression stocking was applied 24 h/day for seven days; subsequently 21–23 mmHg medical compression stocking in daytime. Symptoms, compliance, skin findings, and bioimpedance spectroscopy parameters were assessed. Results A total of 94 patients (48 and 49 limbs in groups A and B, respectively) were enrolled. Three (T3) and seven (T7) days post-operatively, most symptoms were significantly milder in group B, especially pain and heaviness at T7 and at day 40 (T40). Ambulation, medical compression stocking stability/tolerability and skin healing were significantly better in group B, with p = 0.046, 0.021/0.060, and 0.010, respectively, at T7. Bioimpedance parameters increased at T7 and decreased at T40 in both groups; leg reactance and limb L-Dex improved in group B at T7 and T40, respectively (p = 0.039 and 0.012). Conclusions Compression with 23 and 35 mmHg medical compression stocking after catheter foam sclerotherapy + phlebectomy was effective and well tolerated at immediate/short term. Compression with 35 mmHg medical compression stocking provided less adverse post-operative symptoms and better tissue healing. Bioimpedance results confirmed a slightly better edema improvement with 35 mmHg medical compression stocking.

Varicose veins and chronic venous insufficiency

VASA ◽  
2009 ◽  
Vol 38 (4) ◽  
pp. 293-301 ◽  
Author(s):  
Partsch
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Single Case ◽  
Clinical Stage ◽  
Clinical Signs ◽  
Venous System ◽  
High Recurrence Rate ◽  
Therapeutic Concepts ◽  
Venous Disorders

Varicose veins are a very frequent disorder with prevalence in our adult population between 14 % for large varices and 59 % for small teleangiectasias. Subjective symptoms may be very non-specific. The term “chronic venous insufficiency (CVI)” defines functional abnormalities of the venous system producing advanced symptoms like oedema, skin changes or leg ulcers. Both entities, varicose veins and CVI, may be summarized under the term “chronic venous disorders” which includes the full spectrum of morphological and functional abnormalities of the venous system. A classification system to describe chronic venous disorders regarding clinical appearance, etiology, anatomical distribution and pathophysiology has been proposed under the acronym of CEAP. The revised version of the CEAP classification contains also definitions of clinical signs and suggests three levels of apparative investigations adjusted to the clinical stage. Concerning the etiology of venous disorders controversial theories exist leading to different therapeutic concepts. As a matter of fact there is a vicious circle between structural changes in valves and venous wall and hemodynamic forces leading to reflux and venous hypertension. Different methods for treating varicose veins are available producing satisfactory early outcome in most cases, but followed by a high recurrence rate after years. Chronic venous insufficiency requires “chronic management”. Compression therapy by bandages for initial treatment of severe stages and maintenance therapy using medical compression stockings is essential. In addition correction of venous refluxes by surgery or endovenous procedures including echo-guided foam sclerotherapy should be considered in every single case.

Serious Lower Extremity Venous Injury Management with Ligation: Prospective Overview of 63 Patients

2007 ◽  
Vol 73 (10) ◽  
pp. 1039-1043 ◽  
Author(s):  
Mehmet Kurtoglu ◽  
Hakan Yanar ◽  
Korhan Taviloglu ◽  
Emre Sivrikoz ◽  
Rebecca Plevin ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Primary Repair ◽  
Oral Anticoagulants ◽  
International Normalized Ratio ◽  
Compression Stocking ◽  
Compression Stockings ◽  
Vein Thrombosis ◽  
Venous Injury ◽  
Arterial Repair ◽  
Arterial And Venous Injuries

Management of lower extremity venous trauma using repair or ligation has been an area of controversy during the past decades. However, in unstable patients or if primary repair is technically impossible as a result of extensive disruption of the vein, ligation is recommended. This study investigated the effects of venous ligation on major veins in the lower extremities when primary repair is impossible as a result of extensive laceration of the vein. Between January 2001 and April 2004, 63 patients with Grade III and IV venous injuries were observed prospectively. Compression ultrasonography was performed postoperatively on the fifth day, once before discharge, and at the 3-month visit to assess deep vein thrombosis (DVT) and the patency of arterial repair. If DVT was present, the patient was given an oral anticoagulant (warfarin Na) for 3 months (international normalized ratio, 2.0–3.0), and Class II compression stockings (Sigvaris-212, Ganzoni, Switzerland) were used for 1 year. Follow-up visits occurred at 1, 3, 6, and 12 months and at 6-month intervals thereafter. Combined arterial and venous injuries were present in 50 (79.4%) patients and pure venous injuries were present in 13 (20.6%) patients. DVT developed in 49 patients (77.7%; postoperative n = 37 [58.7%], late n = 12 [19%]). Three arterial restenoses (4.7%) and one pseudoaneurysm (1.6%) of the superficial femoral artery developed. Five early (prophylactic) and two late (compartment syndrome) fasciotomies were performed. Postoperative edema was seen in 56 (88.8%) patients and wound infection was seen in 19 patients (30.1%; n = 18 superficial, n = 1 deep). Two amputations (3.2%) were performed. One patient (1.7%) died as a result of irreversible shock. After a median of 18 months, 25 patients were classified with Clinical Etiology, Anatomy, Pathology classification: 10 legs C-0, seven legs C-2, and eight legs C-3. No severe postthrombophlebitic syndrome was observed. Early leg swelling after venous ligation was the most common morbidity. We observed no significant sequelae of chronic venous insufficiency, and venous ligation had no detrimental effect on associated arterial repair. In cases of DVT, anticoagulation with low-molecular-weight heparin and oral anticoagulants should begin immediately and continue for 3 months along with compression stocking support for 1 year.

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