Compression stocking medical

Authors:Prof. Dr. med. Peter Altmeyer, Prof. Dr. Stefanie Reich-Schupke

All authors of this article

Last updated on: 29.10.2020

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Synonym(s)

but the description is not correct: support stocking; elastic stockings; FMD; FMD often used synonymously

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DefinitionThis section has been translated automatically.

Medical stocking manufactured according to RAL standard, available in different pressure classes (compression classes I-IV see table) and designs. The compression classes are defined according to the resting contact pressure in the ankle area.

Features:

  • highest pressure in the ankle area
  • decreasing pressure from distal to proximal
  • Production as round or flat knitted material
  • various designs as custom-made or series production

S.u. Compression therapy.

General definitionThis section has been translated automatically.

Types commonly used:

  • Knee stocking AD
  • Thigh Stocking AG
  • Pantyhose AT

Comparison of the contact pressure in the ankle area with compression stockings in different sizes countries (mmHG). Up to now there is no international standard for the definition of the different compression classes. Pressure values given in mmHg

Country KKL I KKL II KKL III KKL IV
Germany 18-21 23-32 34-46 >49
UK 14-17 18-24 25-35 -
France 10-15 15-20 20-36 >36
USA 15-20 20-30 30-40 -

EffectsThis section has been translated automatically.

The following effects could be shown in prospective, randomized and controlled studein.

  • Reduction of the vein cross section
  • Acceleration of the venous and lymphatic return flow
  • Improvement of the venous valve function
  • Reduction and prevention of limb edema.

For the compression stocking class I (KKL I) the following applies: Compared to a placebo stocking with 3-6mm HG, a 10-15mm HG class I stocking showed a significant improvement in venous complaints, especially venous oedema. The evidence of the benefits of compression stockings led to the inclusion of class I compression stockings in the list of medical aids as early as 2005, so that even the KKL I can be prescribed at the expense of health insurance companies.

IndicationThis section has been translated automatically.

  • Varicosis:
    • Varicosis primary and secondary
    • Varices during pregnancy
    • Support of the sclerotherapy
    • after venous surgery.
  • Thromboembolism:
    • Thrombophlebitis (superficial) and condition after healed phlebitis
    • deep vein thrombosis
    • Condition after thrombosis
    • postthrombotic syndrome
    • Thrombosis prophylaxis for mobile patients.
  • Chronic venous insufficiency (CVI):
    • CVI of stages I to III according to Widmer or C1S-C6 according to CEAP
    • Ulcer prevention and ulcer therapy
    • Guiding vein insufficiency
    • Angiodysplasia.
  • Edema:
    • Lymphedema
    • edema during pregnancy
    • post-traumatic edemas
    • postoperative oedemas
    • cyclic idiopathic edema
    • Lipedema from stage II
    • Congestion due to immobility (arthrogenic congestion syndrome, paresis and partial paresis of the limb).
  • Other indications:
    • Condition after burns
    • Scar treatment.

ContraindicationThis section has been translated automatically.

Absolute contraindications: Advanced AVC, decompensated heart failure, septic phlebitits, phlegmasia coerulea dolens.

Relative contraindications: weeping dermatoses, intolerances or allergies to the material (very rare!!!!), peripheral polyneuropathies, rheumatoid arthritis.

Remember! Unsuitable compression stockings can cause skin necrosis and nerve pressure damage!

Note(s)This section has been translated automatically.

  • Remember! Compression therapy is divided into a decongestion phase and a maintenance phase. Compression bandages are more suitable for the decongestion phase and compression stockings for the maintenance phase.

  • There are special ulcer compression stockings for the treatment of people suffering from ulcus cruris
  • In the majority of cases, a serial fitting is possible; in the case of a special body shape or high compression classes, a custom-made fitting is required. This must be noted on the prescription.
  • All compression stockings are fitted after previous treatment (- also the serial stockings!!!). The measurements are taken on the standing patient in a state as free of oedema as possible (in the morning!).
  • If the patient is not physically able to put on a high class compression stocking, two low class compression stockings can be put on top of each other. In this case not only the resting pressures are added, but also the rigidity of the resulting compression and thus the working pressure increases due to the addition of the materials.
  • If the patient is not able to put on or take off the medical compression stockings, this can also be prescribed by a doctor and carried out by a nursing service. Since 12/2017 this prescription can be made for all classes of foot and mouth disease.

LiteratureThis section has been translated automatically.

  1. Junger M, Sippel K (2003) Compression therapy for chronic venous insufficiency. dermatologist 54: 1045-1052
  2. Stücker M et al. (2016) Evidence of compression therapy with special regard to compression stockings of compression class I. Vasomed 28: 20-21
  3. Travers JP, Makin GS (1994) Reduction of varicose veins recurrence by use of postoperative compression stockings. Phlebology 9: 104-107
  4. Wienert V et al (2006) Guidelines on medical compression stockings (MCS). http://guidelines.net
  5. https://www.g-ba.de/presse/pressemitteilungen/726/

TablesThis section has been translated automatically.

Pressure classes of compression stockings and suggested indications. There is no binding assignment of compression classes and indications. The prescription is subject to medical freedom of therapy.

Compression classes

Effect

Pressure in heel area [mm Hg]

Pressure in heel area [kPA]

Indications

Class I

Light compression

18-21 mm Hg

2,4-2,8

Feeling of heaviness and fatigue in the legs with low varicosis without significant tendency to oedema

Pregnancy varicosis

class II

Medium strength compression

23-32 mm Hg

3,1-4,3

stronger complaints

pronounced varicosis

Oedema tendency

post-traumatic swelling

after superficial thrombophlebitis

after sclerotherapy and varicose vein surgery to fix the success of the treatment

for more severe varicosis during pregnancy

Class III (or 2 class II stockings)

Powerful compression

34-46 mm Hg

4,5-6,1

postthrombotic sequelae

Severe chronic venous insufficiency

severe oedema

after healing of severe and recurrent ulcers

severe lymphedema

class IV

Extra strong compression

> 49 mm Hg

6,5 and above

severe lymphedema

Elephantiasis

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Last updated on: 29.10.2020