Naked Science Forum
General Science => General Science => Topic started by: alun006 on 18/12/2008 12:58:47
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Is it right to think that when you wear a compression sock, even though you may benefit from the pressure used to divert the blood flow round the legs from the faulty veins. It may cause back pressure elsewhere that could cause more complications in the surrounding area.
This question may be interesting to people on long haul flights because these stockings or flight socks as they are called are meant to prevent deep vein thrombosis.
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RELATED LINKS
This study shows widespread (worldwide) problems with compression stockings. From improperly applying the stockings to inaccurate measurements and fitting, these stockings are not being used appropriately and therefore not helping to prevent the formation of blood clots.
http://nursingsite.blogspot.com/2008/09/widespread-problems-with-compression.html
Anecdotally, staff nurses also reported thigh-high stockings were more difficult to apply than knee-high stockings, and patients complained more about the thigh-length stockings. “The nurses wanted to know whether the thigh-length stockings were associated with more problems than the knee-length,” Winslow said.
http://www.nursezone.com/Nursing-News-Events/more-news.aspx?ID=18307
Independent nurses examined patients at three-month intervals for compliance and for recurrent symptoms of venous thromboembolism. Post-thrombotic syndrome was measured on a number of pre-determined subjective criteria (pain in calf, for instance, or leg oedema) and on objective criteria (for example calf circumference, venous ulcer). A mild-to-moderate disease was defined as a score of 3 or more plus one objective symptom, with severe disease defined as a score of four or more; to qualify these had to occur on two consecutive three-month follow up visits.
http://www.medicine.ox.ac.uk/bandolier/band61/b61-7.html
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Back pressure is an inevitable consequence of applying pressure using a compression stocking!
The heart will continue to pump regardless of the person using a compression stocking or not. So where is that extra pressure going if it has applied pressure resistance to the vessels in the legs then something has to take up the backpressure. So logically a vein should bulge in another area to compensate for this. So would be a vein or indeed an artery (embolism) near a main vein / artery junction above the point where the compression stocking has been fitted.
I know you have more to tell us on this subject and hope doctors, nurses and surgeons using this forum will sit up and take note, rather than skulking off without so much as reply to your valid posts.
Andrew
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This "The heart will continue to pump regardless of the person using a compression stocking or not. So where is that extra pressure going if it has applied pressure resistance to the vessels in the legs then something has to take up the backpressure. So logically a vein should bulge in another area to compensate for this. " would be true if it were not for the presence of baroreceptors that monitor blood pressure and reduce the heart rate to compensate.
If these didn't work you would faint every time you got out of bed.
The article cited says this “I would like all nurses who care for patients with graduated compression stockings to appreciate the effectiveness of the stockings in preventing DVT when correctly sized and used and the serious problems if not sized and used correctly.”
From that quote it's clear that the author thinks that, applied correctly, these stockings offer a benefit to the patient.
Of course, if they are not used properly they may cause problems. No suprise there- same as everything else in medicine.
The 3rd article says
"Over a minimum period of 60 months, 19 patients with stockings had mild-to-moderate post-thrombotic syndrome, of whom six went on to have severe disease. Another five developed severe post-thrombotic syndrome without mild-to-moderate disease first. Overall, 72 of 96 patients (75%) were free of post-thrombotic syndrome at 60 months.
Over the same period, 46 patients without stockings had mild-to-moderate post-thrombotic syndrome, of whom 23 went on to have severe disease. Another 13 developed severe post-thrombotic syndrome without mild-to-moderate disease first. Overall, 39 of 98 patients (40%) were free of post-thrombotic syndrome at 60 months. "
So, with stockings 75% free of symptoms, but without stockings only 40% without symptoms.
Looks like convincing evidence in favour of the stockings.
Now, what was that about skulking off?
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Hi Bored Chemist
Thankyou for contributing to this thread.
I will not make out that i have a vast knowledge of the vascular system, but do question the way in which compression stockings are used.
ie : Sister in Law was told that she had 2 varicose veins on both legs. It was pointed out that they would not operate on them as they were not at stage 4, which is when the stripping procedure would be offered.
My sister in law has constant pain in the 2 veins, aswell as a job where she stands all the time.
She asked about compression stocking, and was not offered any. But adviced to go to a high street retailer to purchase some herself.
How does that justify a compression stocking being fitted properly to a ladie that has pain with her varicose veins?
Thankyou alun006
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Varicose veins occur when blood collects behind the small valves in a person’s veins instead of flowing smoothly back to the heart. They are more common in the legs and feet, because blood returning to the heart has farther to travel.
Doctors often recommend compression stockings to improve circulation, stop varicose veins from getting worse, and reduce pain or discomfort. Compression stockings are traditionally used to improve circulation.
Modern compression stockings are more sophisticated and designed to provide consistent pressure in the legs, helping blood to flow back toward the heart. Stockings usually exert more pressure near the ankles and feet, providing an extra squeeze that promotes blood flow.
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Compression garments have been shown to prevent the onset of symptoms of varicose veins after exercise or at the end of the day. Scientists from Macy University in Auckland found that 93% of patients with varicose veins experience leg pain without compression socks, and only 14% of subjects wearing compression socks also experienced similar pain after exercising or taking a long walk.