Name of the Procedure:

Gradient compression stocking, thigh length, 18-30 mmHg

• Common Name: Compression Stockings
• Medical Terms: Gradient Compression Stockings, Thigh High Compression Hose

Summary

Gradient compression stockings are specially designed hosiery that provide graduated compression to help manage venous disorders and improve circulation. The stockings exert more pressure at the ankle and gradually decrease pressure up the leg, aiding blood flow back to the heart.

Purpose

• Medical Conditions Addressed: Varicose veins, chronic venous insufficiency, post-thrombotic syndrome, edema, and lymphedema.
• Goals: Improve blood circulation, decrease swelling, prevent blood clot formation, and provide relief from symptoms associated with venous insufficiency.

Indications

• Swelling in the legs and ankles
• Varicose veins
• Venous leg ulcers
• Post-thrombotic syndrome
• Patients with a high risk of deep vein thrombosis (DVT)
• Standing or sitting for long periods

Preparation

• Measure legs to ensure correct sizing
• Clean and dry legs before application
• No fasting or major medication adjustments needed
• Ensure any pre-existing skin conditions are assessed by a healthcare provider

Procedure Description

1. Measure the leg circumference and length to determine the proper stocking size.
2. Roll the stocking inside out up to the heel and place the foot into the stocking.
3. Gradually unroll the stocking up the leg, smoothing out wrinkles.
4. Ensure the stocking fits snugly but not too tight and that the top lies flat against the skin.

Tools/Equipment: Measuring tape, gradient compression stockings of specified pressure (18-30 mmHg).

Anesthesia/Sedation: Not applicable.

Duration

• Approximately 5-10 minutes to don the stockings properly.

Setting

• Typically performed at home, outpatient clinic for initial fitting and instructions.

Personnel

• Initial fitting by a healthcare provider, such as a nurse or a physical therapist.
• Self-application by the patient after initial guidance.

Risks and Complications

• Skin irritation or ulcers if the stockings do not fit properly.
• Discomfort if worn too tightly.
• Possible allergic reaction to the material.

Benefits

• Alleviates symptoms of venous insufficiency.
• Reduces leg swelling and pain.
• Prevents the progression of varicose veins and other venous disorders.
• Benefits can typically be felt immediately or within a few days of consistent use.

Recovery

• No recovery time; daily wear is recommended.
• Regular washing and inspection of stockings.
• Follow-up appointments, if necessary, to reassess the fit and condition of the legs.

Alternatives

• Elevation of legs to reduce swelling.
• Regular physical activity and leg exercises.
• Pharmacological treatments with diuretics or vein tonics.
• Surgical options like vein stripping, sclerotherapy, or endovenous laser treatment.

Pros and Cons:

• Compression Stockings: Non-invasive, cost-effective, immediate effect, but require daily wear and proper sizing.
• Surgical Options: More permanent solutions but involve greater risks, costs, and recovery time.

Patient Experience

• Initially, patients may feel tightness or slight discomfort.
• Most patients adapt within a few days.
• Pain management via proper sizing and gradual adjustment to wearing time.
• Comfort measures include wearing cotton liners and ensuring proper hygiene.

By understanding and following these guidelines, patients can effectively use gradient compression stockings to manage their venous conditions and improve their quality of life.