IMPORTANCE OF STOCKINGS IN VARICOSE VEIN MANAGEMENT

 What are Graduated compression Stockings?

  • They are narrower at the ankle and become wider as they go up.
  • The aim is to promote a pressure gradient which pushes blood from the ankles towards the heart, thereby supporting the veins in their primary function of returning blood to the heart.

What do these stockings do?

  • They provide outside compression and thus prevent the superficial veins(which you can see or feel) from distending(filling up), thereby causing the blood to drain into the deeper veins(those which you cannot see).
  • Because of the outside compression of tissues, the deeper veins are also not able to distend especially if they have damaged valves (which is there in patients who have discolouration of the legs, ankle ulcers, thickening of skin in the leg).
  • Thereby the blood finds it easier to make its way back to the heart.

Subjectively you feel a significant reduction in 

  1. leg swelling, 
  2. less aching , 
  3. less cramps, 
  4. less tiredness…especially towards the end of the day.

Patients report that their symptoms reduce significantly on wearing the stockings. Studies have also shown that skin oxygenation improves after wearing the stockings.

Over a period of time, the stockings cause a reduction in thickness of the skin which happens in patients with long standing venous insufficiency. This helps in reduction of symptoms and complications especially ulcers and bleeding.

Sometimes if the skin thickness is considerable, we may recommend use of the stockings for a few months before surgery, so as to enable you to get a better result and shorter hospital stays and faster recovery.

                                  Optimum use of Stockings

Regular use of the compression stockings is an important factor for keeping your vein system healthy. Avoidance of the stockings commonly occurs due to 

  1. The stockings are too tight, and the patient finds it difficult to wear. Usually at the time the stockings are prescribed and given you must ask your doctor to show you how to put on the stockings in the proper way with least effort
  2. Some patients feel a sense of discomfort/tightness with the stockings. These feelings are common especially when you first start wearing them, but should go away in a few days. In some cases it may be better to start with a lesser compression stocking before moving on to the recommended compression grade.
  3. The stockings may have a tendency to bunch up around the ankle or around the knee, whereby it may cause constriction (rubber band effect) in the area and cause an ulceration/skin damage. That is why knowing how to wear the stocking and preventing it from bunching up is important for compliance.