Medical Compression Stocking Treatment In Vein Diseases
The veins return blood to the heart from all the organs of the body. The main problems of the veins include inflammation, clotting and defects that lead to distension and varicose veins
The legs contain two major groups of veins: the superficial veins, located in the fatty layer under the skin and the deep veins, located in the muscles. Short veins connect the superficial and deep veins. Blood pressure in all veins is normally low and in the leg veins, is low pressure can pose a problem. Blood has to flow from the leg veins upward to reach the heart when a person is standing. The deep veins play a major role in propelling blood upward. Located within the powerful calf muscles, these veins are forcefully compressed with every step.
Varicose veins are enlarged superficial veins in the legs. The precise cause of varicose veins is not known but it is probably a weakness in the walls of the superficial veins. This weakness may be
inherited. Overtime, the weakness causes the veins to lose their elasticity.
When valves become incompetent the cycle of unidirectional blood flow is interrupted and backflow of blood occurs. This is most significant when the backflow blood occurs between the deep and superficial veins, as the increased pressure in the superficial veins will cause further valve incompetence. This is because the valve cusps no longer meet as a result of the streching of veins. The overall effect of this increased superficial hydrostatic pressure is the formation of tortous varicose veins.
If this increased hydrostatic pressure is not treated it leads to chronic venous insufficiency which in turn result in oedema, lipodermatosclerotic changes, varicose eczema and ulceration. External compression applies controlled pressure to the skin. This then supports the superficial venous system, helping to reduce the increased hydrostatic pressure and redress the balance between the deep and superficial veins. This helps in reducing oedema and aiding venous return. Unlike compression bandaging with its high working pressure, medical compression stockings exert a resting pressure. The daily build-up of pressure is controlled by the limited ability of the hosiery to strech, so incompetent venous valves are approximated, venous return is accelerated, the fibrinolytic activity of the venous wall is increased and the risk of thrombosis reduced. Medical Compression stockings exert an external pressure which is greater at ankle and reduces at the calf and thigh, thus increasing blood velocity within the deep venous system. How much pressure to apply is recognised that the amount of pressure required is dependent on the severity of the condition.
Severe venous hypertension is associated with oedema, eczema, skin pigmentation, induration and ulceration. It can be seen that the management of these conditions will require a higher level of
compression than conditions such as mild varicose veins and oedema.
Light (18- 21 mmHg) Compression Stockings:
- For prevention of venous disease
- For slight varicosis without oedema and for early varicosis in pregnancy
- The diseases such as diabetes and rheumatism which lead to venous weakness and loss of elasticity
- For treatment after vein operations
Medium (23-32 mmHg) Compression Stockings :
- For pronounced varicosis with a tendency to oedema
- For post-traumatic swelling
- For recovery period of simple ulcers
- For superficial thrombophelebitis
- For treatment after vein operations and scleroteraphy
- For pronounced varicosis in pregnancy
Strong (34-46 mmHg) Compression Stockings:
- For severe conditional and post-thrombotic venous insufficiency
- For pronounced varicosis with oedema
- For secondary varicosis
- For dermatosclerosis
- For recovery period of serious and recurrent ulcers (after healing of ulcer)
Extra Strong (over 49 mmHg) Compression Stockings:
- For lymphatic oedema
- For elephantiasis
- Progressive periphery arterial congestion disease
- Decompensated heart diseases
- Septic phlebitis
- Phlegmasia coerulea dolens
- Wetting dermatosis
- Incompability to compression stocking fabric
- Sensibility disturbances of the limb
- Progressive periphery neuropathy