The Structure and Compression of Medical Compression Stockings

This paper lays out standards of compression stockings and their classification into classes. The analysis of knitted fabric structure parameters, elongation and compression of moderate- and high-compression stockings was conducted. Stocking compression on specific parts of the stocking leg was measured on three sizes of a wooden leg model. For moderate-compression stockings, compression above the ankle was 32 hPa. For high-compression stockings, compression above the ankle was 60 hPa. Both groups of the analyzed compression stockings were made on modern one-cylinder hosiery automats. The legs of the stockings were made in single inlaid jersey 1 + 1. Both yarns were elastane covered. The finer yarn formed loops and its knitting into a course was significantly larger than in the other yarn, which was much coarser and does not form loops but “lay the weft in a bent way”. The smallest elongation of knitted fabric was above the ankle, where the highest compression was achieved, while the largest elongation was under the crotch, where the stocking leg exerted the smallest compression on the surface. The leg of the compression stocking acted as a casing that imposed compression on the leg and often reinforced it to be able to sustain compression loads.

Influence of Medical Compression Stockings on Skin Hydration in Mainly Health Care Givers with Occupational Leg Symptoms and Edema

Background and Objective: Although compression therapy is a very effective therapy in reducing stasis-induced complaints, the wearing comfort is not always as requested. Most frequent problems are dryness of the skin and itching. This randomized, cross-over trial investigated 33 healthy participants and compared 2 different medical compression stockings: conventional stockings (type A = MCS) versus compression stockings with integrated care emulsion (type B = MCS-SkC). Methods: Participants were divided into 2 cohorts. Both compression types were worn one after the other, 1 week each. The cohorts were named according to the sequence of the wearing periods (cohort AB/BA). Primary outcome: skin hydration. Secondary outcomes: transepidermal water loss (TEWL), skin roughness, leg volume, interface pressure, and questionnaires about stasis-induced complaints and wearing comfort. Results: Skin hydration: significant reduction after wearing MCS in both cohorts (p < 0.001); preservation of skin moisture after wearing MCS-SkC (p = 0.546 and p = 0.1631). TEWL: significant increase after wearing MCS (p = 0.007 and p = 0.0031); significant reduction by wearing MCS-SkC (p = 0.006 and p = 0.0005). Skin roughness: significant increase after wearing MCS (p = 0.0015 and p = 0.010), and nonsignificant decrease of skin roughness after wearing MCS-SkC (p = 0.933 and p = 0.4570). Leg volume: significantly reduced with both stockings (p = 0.004 and p = 0.0047). Regarding stasis-induced complaints, both stockings achieved good results. Conclusions: Both compression stockings are appropriate to reduce leg edema and minimize leg symptoms. MCS-SkC helps to obtain the natural skin barrier function in preserving the epidermal water content and reducing the TEWL.

Safety of medical compression stockings in patients with diabetes mellitus or peripheral arterial disease

IntroductionCompression therapy is highly effective in the treatment of many venous diseases, including leg edema. However, its relevance in patients with peripheral arterial disease (PAD) or diabetes mellitus is critically discussed. The aim of the present study was to assess the influence of compression therapy on microperfusion and its safety in patients with PAD or diabetes mellitus.Research design and methodsA prospective analysis of 94 consecutive patients (44 patients with diabetes, 45 patients with PAD and 5 healthy controls) undergoing medical compression therapy was performed. Microperfusion was assessed by a combined method of white light tissue spectrometry and laser Doppler flowmetry under medical compression therapy (classes I and II), in different body positions (supine, sitting, standing and elevated position of the leg) and at different locations (great toe, lateral ankle and calf).ResultsDuring the entire study, no compression-related adverse events occurred. Evaluation of microcirculation parameters (oxygen saturation of hemoglobin and flow) at the different locations and in sitting and standing positions (patients with diabetes and PAD) under compression therapy classes I and II revealed no tendency for reduced microperfusion in both groups. In contrast, in the elevated leg position, all mean perfusion values decreased in the PAD and diabetes groups. However, the same effect was seen in the healthy subgroup.ConclusionsIn consideration of the present inclusion criteria, use of medical compression stockings is safe and feasible in patients with diabetes or PAD. This study did not find relevant impairment of microperfusion parameters under compression therapy in these patient subgroups in physiologic body positions.Trial registration numberNCT03384758.

Medical compression stockings on the skin moisture in patients with chronic venous disease

Summary: Background: Because of side effects like skin dryness and consecutive symptoms like itching the therapy of chronic venous insufficiency (CVI) with medical compression stockings (MCS) can lead to a diminished wear comfort and restricted compliance. Compression stockings with integrated skin care may have a positive influence on the skin hydration and moreover a positive effect on patients compliance. Patients and methods: In this monocentric, randomized prospective, controlled trial a below knee conventional MCS was compared to a medical compression stocking with integrated skin care (MCS-SC), interface pressure range 23–32 mmHg. Participants: 50 patients with CVI. Primary outcome: skin hydration. Secondary outcomes: transepidermal water loss, skin roughness, leg volume, interface pressure and questionnaires about quality of life and wear comfort. Results: In patients wearing MCS the skin moisture decreased (p = 0.021) and the skin roughness increased significantly (p = 0.001), whereas in patients wearing the MCS-SC skin moisture and skin roughness changed only slightly (n.s.). These protective effects of MCS-SC compared to MCS were most common in patients with CVI at stage 3 (p = 0.046), in male patients (p = 0.013) and patients with initial dry skin (p = 0.034). Both MCS reduced lower leg volume, MCS by 80 ml (p < 0.001) and MCS-SC by 60 ml (p < 0.001), both MCS improved quality of life: leg complaints (p = 0.0003); functional status (p = 0.010), well-being and life satisfaction (p = 0.030). Wear comfort: In terms of tightness, constriction in bond area and strenuous donning the MCS-SC was assessed significantly more comfortable than MCS (p < 0.001). Conclusions: MCS-SC revealed to be superior to MCS with regard to skin moisture, particularly in patients with low skin humidity, in male patients and in patients with C3, varicose veins accompanied by edema.