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Compression garments for vein problems

Compression garments are evidence-based medical treatments for vein problems.

How do compression garments work to support veins?

The video below by Sigvaris shows how veins can be supported through compression therapy.

What is compression therapy?

  • Garments
  • Pneumatic compression pumps
  • Bandaging

What are the types of vein problems that may benefit from compression?

Diseases of the veins include:

Blood clots (thrombosis)

Thrombosis can occur in the legs, arms, veins of the internal organs (kidney, spleen, intestines, liver, pelvic organs), brain (cerebral vein thrombosis), kidneys (renal vein thrombosis), or lungs (pulmonary embolism).

Thrombosis of a deep vein

Deep vein thrombosis (DVT) is a blood clot that forms in a deep vein (including the upper extremities — arms — and lower extremities — legs). Even though deep vein thrombosis is not life-threatening, the blood clot has the potential to break loose and travel through the bloodstream, where it can lodge in the lung’s blood vessels (known as a pulmonary embolism). This condition is potentially fatal.

There is high-quality evidence that graduated compression stockings are effective in reducing the risk of DVT in hospitalised patients who have undergone general and orthopaedic surgery.

Thrombosis or phlebitis of superficial veins

A blood clot that forms in a vein close to the skin’s surface is known as superficial venous thrombosis or phlebitis. Typically, these types of blood clots do not travel to the lungs unless they first enter the deep venous system. However, they typically result in discomfort.

Chronic venous insufficiency

Chronic venous insufficiency is characterised by blood pooling, chronic leg oedema, increased pressure, increased skin pigmentation or discoloration, and leg ulcers known as venous stasis ulcers.

Varicose and spider veins

Varicose and spider veins are abnormal, dilated blood vessels caused by a deterioration of the blood vessel wall.

Ulcers

Blood flow stagnation or venous stasis is the cause of ulcers. Ulcers are wounds or open sores that fail to heal or recur. The majority of venous stasis ulcers are found on the inner aspect of the lower leg, just above the ankle, and below the knee.

For elderly people (aged over 70 years) that have been found to have had an ulcer in the past, graduated compression stockings in class 2 probably reduce the risk of leg ulcer recurrence compared to compression stockings class 1.

How can compression therapy help vein problems?

Compression therapy is an evidence-based method for helping with venous problems.

A Cochrane review stated that, “Graduated compression stockings (GCS) help prevent the formation of blood clots in the legs by applying varying amounts of pressure to different parts of the leg.”

Best practice for the management of venous ulcers and venous insufficiency involves pressure garments.

Compression therapy is the mainstay treatment for venous ulcers. [Jindal et al, 2018]

What makes compression therapy effective for vein problems?

Being applied EARLY

Compression is much more likely to be effective when applied early. Vein problems progress through stages. When very early signs of swelling are present or even before swelling occurs is the ideal time for when compression therapy should start to be won.

Being the correct pressure

Medical compression garments are prescribed at a set dosage of pressure. They need to be replaced every 4 to 6 months depending on the brand and how much wear they receive.

Compression garments should be graduated and tested for safety and quality. You should only buy reputable brands of medical compression garments.

Being the correct compression class

“In general, though, low compression refers to pressure of less than 20 mm Hg or class 1; medium compression to pressure of 20–30 mm Hg or class 2; and high compression to pressure of greater than 30 mm Hg, or class 3 or higher. The overall pressure is affected by factors such as the elasticity and stiffness of stocking material, the size and shape of the wearer’s legs, and the movements and activities of the wearer.” [Sim Lim and Davies, 2014]

Being comfortable

Compression garments should only be applied safely and they should not hurt! If they cause discomfort they should be removed. There are lots of brand options, styles and fabrics available to ensure that everyone can get the right compression option for their needs.

For example:

  • patients with diabetes and wound on their feet do not have to have compression on their feet – they can wear leg wraps to control ulcers and venous insufficiency which go from the ankle up to knee. This leaves the foot area free.
  • patients with painful wounds can use compression pumps that have chambers that can be tuned off over the painful wound
  • patients with severe venous insufficiency can wear strong flat knit garments to control the swelling or wraps
  • patients with mild venous problems and varicose veins can wear circular knit garments that look like normal socks. No one even needs to know that patients are wearing compression therapy as they can look like normal, stylish clothing.

A qualified lymphoedema practitioner can assist you with your compression needs. You can find them via www.instituteoflymphoedema.com.au/canfind