Effect of Long-Distance Flights on Oedema of the Lower Extremities

Abstract

Objective: During long-distance flights, passengers complain of leg heaviness and oedema in the feet, ankles and distal parts of the lower extremities. Among the rarer complications are thrombophlebitis, thrombosis and pulmonary embolism. The aim of this study was to compare the efficacy of class II elastic stockings with no stockings and a venoactive compound (dried extract of vine leaves) and with a diuretic combination for preventing venous oedema during a long-distance flight. Design: Open, randomized study on outward-bound and return flights, volunteers having been administered the venoactive compound Antistax ( n = 13) or no medication ( n = 13); nine subjects received the fixed diuretic combination only on the outward-bound flight. Each subject ( n = 35) wore a class II compression stocking (Sigvaris 902/A-D) on one leg. Main outcome measures: Water displacement volume measurements of the lower limb; secondary end-points: clinical oedema, subjective symptoms, phlebological status, clinical and Doppler findings. Results: The most effective measure in preventing lower limb oedema was the individually fitted elastic support stockings. The venoactive drug Antistax was ineffective. The diuretic combination did have an effect in combination with the compression stocking. Conclusion: During long-distance flights, compression stockings are more effective in preventing oedema in the lower limbs than the venoactive dried extract of vine leaves. The diuretic combination had a marked effect in combination with compression.

Graduated compression stockings (20−30 mmHG) do not compress leg veins in the standing position

“…Wearing 25-32 mmHg GCS on one leg prevented any appreciable oedema unlike the bare leg, which swelled by 60-120 mL over a 14-h flight. 16 After a 4-h flight the volume of a bare leg was 30 mL greater than a leg supported by GCS. 17 The greater limb volume should increase the compressive effect of the stocking until an equilibrium is reached.…”

The LONFLIT4-Concorde - Sigvaris Traveno Stockings in Long Flights (EcoTraS) Study

“…This study indicates that edema, which is common and observed in almost all subjects, even those with healthy circulation, could be an important prevention issue. 38,39 Specific stockings prevent the development of edema in almost subjects at low-moderate risk for DVT.…”

Medical compression therapy of the extremities with medical compression stockings (MCS), phlebological compression bandages (PCB), and medical adaptive compression systems (MAC)

“…Various studies have shown an improvement in vein symptoms, quality of life, and venous edemas, even with low pressures, as compared to placebo stockings [46,47]. A significant reduction in edemas and symptoms has also been shown in people who work standing up [48,49], after long-haul flights [50], in aircrews [51,52], in chronically immobilized elderly people after sitting still for extended periods [53], and in patients with intradermal varices [54] and CVI [6,7]. MCS improve the symptoms of varicose veins in pregnancy [55,56].…”