Name of the Procedure:

Surgical Stockings Thigh Length (HCPCS A4495) Common name(s): Compression socks, compression stockings
Medical term: Thigh-length gradient compression stockings

Summary

Surgical stockings, also known as compression stockings, are specialized hosiery designed to prevent venous disorders such as swelling and clot formation. These thigh-length stockings promote blood flow and reduce the risk of deep vein thrombosis (DVT).

Purpose

Surgical stockings are primarily used to:

• Prevent the formation of blood clots, especially post-surgery or during long periods of inactivity.
• Reduce swelling and improve blood flow in patients with chronic venous insufficiency.
• Assist in managing symptoms of varicose veins and other venous disorders.

Indications

Compression stockings are indicated for:

• Patients recovering from surgery or those at high risk for DVT.
• Individuals with chronic venous insufficiency or varicose veins.
• Those experiencing swelling or edema, especially in the legs.
• Pregnant women at risk of varicose veins.

Preparation

Preparation for using compression stockings includes:

• Getting measured for the correct size to ensure proper compression and fit.
• No specific fasting or medication adjustments are typically required.
• A physical examination to assess the suitability and identify any contraindications.

Procedure Description

1. Measurement:
   • Leg measurements are taken to ensure the stockings fit correctly, typically around the ankle, calf, and thigh.
2. Application:
   • The stockings are carefully rolled onto the leg, ensuring they are smooth and wrinkle-free.
3. Adjustment:
   • Stockings are adjusted to ensure even compression and optimal comfort.
4. Tools/Equipment:
   • Gradual compression stockings with specified mmHg (millimeters of mercury) levels to ensure adequate pressure gradients.
5. Anesthesia:
   • Not applicable for this non-invasive procedure.

Duration

Typically takes a few minutes to measure and apply the stockings.

Setting

This can be performed in a variety of settings, including:

• Hospital
• Outpatient clinic
• Home, with proper instruction

Personnel

• Nurses or medical assistants for initial fitting and instruction
• Physicians may prescribe the stockings and assess their effectiveness

Risks and Complications

Common risks include:

• Discomfort if not fitted properly
• Skin irritation or rash
• Rare risks include compression sores or worsening symptoms if contraindications exist Management typically involves adjusting the fit or temporarily discontinuing use.

Benefits

• Improved blood circulation
• Decreased risk of DVT and other venous disorders
• Reduced leg swelling and discomfort Benefits are often realized within a few days of consistent use.

Recovery

Post-procedure care includes:

• Regular inspection of the skin for any irritation
• Following instructions for daily wear and removal
• Routine re-assessment for size and compression adequacy
• Patients typically experience immediate improvement with continued use.

Alternatives

Alternative treatments can include:

• Oral medications like anticoagulants
• Physical therapy and regular exercise
• Other types of compression devices, such as pneumatic compression pumps Pros of alternatives: May be more suitable for patients with allergies to the stocking material or severe arterial disease. Cons of alternatives: Might not be as effective in providing consistent gradient compression.

Patient Experience

Patients might experience:

• Tightness around the legs initially
• Improved comfort and reduced symptoms over time Pain management and comfort measures involve ensuring proper fit and gradually increasing wear time to allow adjustment.