What Is Compression Stocking, And How Is It Used?

Compression stocking and varicose vein medication are the two most common treatment options encountered by varicose vein patients when they consult a doctor. In fact, these are not for curative purposes but temporary measures aimed at preventing complaints and providing relief to the patient. Often, patients purchase compression stockings and medication, use the medication for a while, then discontinue it, and wear the stockings a few times before putting them away due to the difficulty of wearing them.

One of the primary complaints about compression stockings is the difficulty in using them. An essential mistake here is providing the stockings without proper measurement or with incorrect measurements. Another mistake is the incorrect use by the patient.

So, what is a compression stocking, or as we say in medicine, compression hosiery? Are they just tight socks that squeeze the leg? Would wearing tight pantyhose serve the same purpose? Or another frequently asked question: doctors prescribe tight stockings, but they also say that tight clothing is not suitable for varicose veins, why?

Firstly, it is worth noting that compression stockings are not just ordinary tight socks. These stockings have a graduated pressure, decreasing from the ankles to the calves, providing gradual pressure. A quality stocking, when used correctly, should exhibit this graduated pressure effect for at least six months.

Having graduated pressure from bottom to top, almost like squeezing the leg upward, the stocking exerts a massage effect. This effect helps reduce the pooling of blood and edema in the lower part of the leg in patients with venous insufficiency or lymphedema. Consequently, it indirectly reduces complaints such as pain, swelling, itching, and cramps caused by this blood pooling.

The primary function in transporting venous blood from bottom to top, towards the heart, relies on the pump created by the contraction of muscles in the foot and leg area. Especially in those who work long hours standing or sitting, the elderly, those who do not engage in physical activity, and obese individuals, these muscles may become sluggish and fail to perform this function adequately. This is when compression stockings become necessary to support the function of this muscle pump. Engaging in sports to activate leg muscles will reduce the need for stockings.

Why Are Compression Stockings Used?

We use compression stockings for two main purposes. Firstly, for the prevention of complaints and complications and for monitoring. In such cases, it can either be used temporarily or, in chronic cases, such as complications after deep vein thrombosis, it can be used for a more extended period. Examples of preventive use include wearing anti-embolic stockings (very low-pressure compression stockings) before certain surgeries and temporary use during long plane and bus journeys.

The purpose of this usage is to reduce the risk of thrombosis in the veins during periods of inactivity, especially in elderly individuals, those with venous insufficiency, and individuals undergoing specific surgical procedures. This is crucial to prevent the formation of blood clots in the veins, which could potentially travel to vital organs, leading to pulmonary embolism.

The second reason for using compression stockings is entirely for supporting treatment. In such cases, after surgical procedures or non-surgical treatments for venous insufficiency and varicose veins, such as surgery, foam sclerotherapy, laser (EVLA), radiofrequency (EVRF), and adhesive procedures, compression is required to allow the therapeutic effects of the applied treatment on the varicose vein to manifest. With modern non-surgical varicose vein treatments, the duration of compression stocking use has decreased significantly.

In our procedures, we recommend using compression stockings for six weeks after foam sclerotherapy for venous insufficiency in the main saphenous vein, two weeks after foam sclerotherapy for superficial varicose veins, and an additional two weeks after adhesive, EVLA, and EVRF applications.

Care And Usage Of Compression Stockings

When your doctor prescribes compression stockings for you, they will specify the compression level (Class level) and the features of the stockings, such as the length on your leg (below the knee, above the knee, thigh-high, etc.). Other features like the brand and material can be chosen according to your preference.

When the patient goes to the medical supply store with this prescription, it is crucial to take measurements such as ankle, below the knee, heel-to-knee distance, etc., to provide the patient with the most suitable compression stockings.

There are basically 4 classes:

Class 1: 18-21 mmHg pressure, light compression

Class 2: 23-32 mmHg pressure, medium compression

Class 3: 34-46 mmHg pressure, high compression

Class 4: 48-54 mmHg pressure, very high compression

In addition to getting the right size, wearing compression stockings correctly is essential. It is more beneficial to put them on before getting out of bed, without the legs hanging down. If a bath is going to be taken, the stockings can be worn after resting the legs above chest level for about 15 minutes after the bath. Some devices designed for wearing them provide ease of use.

For long-term use, they should be washed daily with lukewarm water and soap suds and dried on a flat surface without sagging.

When Not To Use Compression Stockings

1. Individuals with heart failure
2. Those with advanced arterial disease
3. Individuals with skin diseases with drainage on their legs
4. Individuals with neuropathy (sensory impairment, numbness), often seen in diabetes patients
5. Those allergic to stocking materials