Graduated Compression Treatment in Patients with Chronic Venous Insufficiency: A Study Comparing Low and Medium Grade Compression Stockings

Abstract

Objective. Patients with chronic venous insufficiency (CVI) benefit subjectively from treatment with graduated compression stockings. Usually, class II compression is used in patients with CVl grade n. The present study investigates possible differences between graduated compression of classes I and II. Design. Randomized study. Setting. Department of Vascular Surgery and Vascular Laboratory, University Hospital, Lund. Patients and Methods. Thirty-one patients, nine male and 22 female (59 legs), all with grade II CVI. Foot volumetry and a visual analogue scale (VAS) were used to assess symptoms. Patients were randomized to either class I or class II graduated compression, and the examinations were repeated after 8 weeks of treatment. Results. The VAS assessment showed that all patients benefited to the same extent and there were no differences between the two compression classes. An increase of the expelled volume with compression was recorded, to a significant degree with class I compression. Reflux values were not significantly influenced by either grade of compression. Conclusion. Class I graduated compression did not show any difference in subjective effect or objective parameters compared with Class II. Class I compression can be recommended instead of class II compression, especially in patients who find that the higher pressure on the leg causes discomfort.Correspondence and offprint requests to: Professor Lars Norgren, Department of Surgery. Lund University. 5-221 85 Lung. Sweden.

Graduated compression stockings

“…17 Some studies reported that low-compression stockings were as effective as high-compression stockings but had a better compliance rate. 16,18 A meta-analysis of 11 RCTs reported that compression of 15-20 mm Hg showed beneficial effects on edema and symptoms, as compared with compression of less than 10 mm Hg or no compression; there was no difference between compression of 10-20 mm Hg and greater than 20 mm Hg. 19 There was insufficient evidence to determine which length of graduated compression stocking (below knee or thigh length) was most beneficial.…”

Effects of Preventive Use of Compression Stockings for Elderly With Chronic Venous Insufficiency and Swollen Legs: A Systematic Review and Meta-Analysis

“…The studies were published between 1997 and 2013 and included a total of 684 participants with chronic venous insufficiency. Two studies were from Australia [20,21], one from England [22], one from Ireland [23] and one from Sweden [24].…”

Clinical Benefits of Lightweight Compression: Reduction of Venous-Related Symptoms by Ready-to-Wear Lightweight Gradient Compression Hosiery

“…Therefore class I compression may be recommended over class II since patient compliance is much higher and symptom improvement is identical. 8 Even lighter weight compression has been studied for subjective complaints and objective signs (Doppler measured reflux) of lower extremity venous insufficiency. Over-the-calf compression socks of 6 and 12 mmHg were shown to improve venous insufficiency objectively and subjectively.…”

“…Therefore class I compression may be recommended over class II since patient compliance is much higher and symptom improvement is identical. 8 …”