Compression stockings for the initial treatment of varicose veins in patients without venous ulceration

Graduated compression stockings

“…19 There was insufficient evidence to determine which length of graduated compression stocking (below knee or thigh length) was most beneficial. 6,11 Chronic venous insufficiency Although we found no RCT that compared compression with no compression in patients with venous skin changes (CEAP class C 4 ), it is generally accepted that the management of such patients should include graduated compression stockings if tolerated. 1,20 There is high-quality …”

“…10,11 Commonly cited reasons include pain, discomfort, difficulty donning the stockings, perceived ineffectiveness, excessive heat, skin irritation, cost and appearance. 6,10,12 Clinicians should ask their patients why the stockings are not being used, because many of these factors are easily amenable by simply changing the stocking material, lowering the degree of compression or providing adequate information and reassurance to patients.…”

“…11 Although the participants' symptoms and physiologic measures subjectively improved in all of the studies when graduated compression stockings were worn, there was a risk of bias because the assessments were not made by comparing one randomized arm with a control arm. Another systematic review of graduated compression stockings for uncomplicated varicosities identified 25 studies.…”

Varicose Veins

“…Compression stockings are frequently prescribed as the first step in varicose 9 A multicenter randomized, controlled trial of active versus placebo compression stockings suggested that routine use of compression stockings may not prevent post-thrombotic syndrome in patients with first proximal DVT. 10 Patients should be instructed to don compression stockings in the morning while the legs are in a nondependent position and to remove them at night before going to bed.…”

Compression for Primary Prevention, Treatment, and Prevention of Recurrence of Venous Leg Ulcers

“…While the various clinical guidelines concur that compression is a cornerstone of VLU treatment and prevention, they lack adequate detail concerning which form of compression is best for each patient. 2 , 7 – 9 , 11 , 12 This decision is especially complex, given the variety of influencing factors such as the goal of therapy (primary prevention of venous ulcers in patients with CVI, prevention of ulcer recurrence, or management of a current ulcer), patient tolerance, and variable resources needed to obtain and apply compression.…”