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Compression stockings

Published by Bupa's health information team, April 2009.

This factsheet is for people who wear compression stockings, or who would like information about them.

Compression stockings are usually worn to help maintain circulation within the leg veins and to reduce leg swelling. They are used to treat leg ulcers and varicose veins, and to help reduce the risk of blood clots forming in the veins of the legs (deep vein thrombosis, DVT).

About compression stockings
Wearing compression stockings
How to put on compression stockings
Caring for your compression stockings
Questions and answers
Video
Related topics
Related Bupa products and services
Further information
Sources

About compression stockings

Compression stockings (also called graduated compression stockings) can be used for a number of conditions.

DVT is a condition where a blood clot forms in a deep vein, usually in the leg. If the blood clot breaks loose, it can travel to your lungs and block an artery (this is known as a pulmonary embolism).
Varicose veins are swollen superficial veins (veins that lie under your skin) that look lumpy and dark blue or purple through your skin. They usually affect your legs, particularly your calf and sometimes your thigh, and are caused by damaged valves in your veins. This means that blood can't travel up your veins as easily and tends to pool (collect) in your veins causing them to enlarge.
Venous leg ulcers are areas of skin loss (lesions) usually near your ankle. They are caused by problems with the valves in your leg veins.
Fluid build-up in your legs (oedema) can be caused by heart failure and problems with the veins in your legs. Fluid can also build up in your legs during long aeroplane flights.

How do compression stockings work?

Compression stockings work by putting pressure on the veins in your leg. They are called graduated compression stockings because the pressure they exert is greatest at the ankle and reduces further up your leg. When you walk or exercise your legs they help the natural pump mechanism of the muscles in your leg to improve your circulation.

Compression stockings are available in several sizes and lengths. They are also available with different strengths of compression; Class I to III. Class I stockings apply the least amount of pressure and Class III stockings apply a much higher pressure. Your doctor will advise which strength is appropriate for you.

Wearing compression stockings

To be effective, stockings need to be worn constantly during the day. Usually you should remove your stockings before you go to sleep, but your doctor may advise you to wear the stockings at night. However, you should take them off for at least half an hour every day to wash your legs and check the condition of your skin.

When checking your skin you need to look out for:

any sore marks at the top of your legs
any sores on your toes or feet

If you spot any of these signs, or if you're worried, don't put your stockings back on and talk to your GP.

You should also take care to prevent your skin becoming dry by applying an emulsifying cream to your legs. Your GP can recommend creams that are appropriate for you.

Wearing compression stockings for surgery

Hospitals often do a pre-operative risk assessment for DVT, which takes into account your health and the type of treatment or surgery you're having. Your surgeon will recommend appropriate preventive measures for you.

You may be asked to wear low-pressure compression stockings (also called anti-embolitic, or thrombo-embolus deterrent - TED - stockings) before your surgery and to continue wearing them during your hospital stay. You may need to have an injection of an anticlotting medicine called heparin as well as, or instead of, stockings.

Compression stockings are available in several sizes and lengths. Your nurse will measure your legs and recommend the correct compression stockings for you. Stocking size and length will be recorded but it may be necessary to re-measure your legs if they are swollen after surgery.

Your nurse will show you how to put the stockings on and may also give you advice about washing and taking care of your stockings once you're at home.

Your nurse will also teach you foot and ankle exercises that will help encourage blood flow through your legs.

You may still be at risk of DVT after going home from hospital, depending on your health and the type of treatment or surgery you have had. If necessary, your surgeon will ask you to continue wearing your stockings at home for a few weeks.

Wearing compression stockings for travelling

If you're travelling for a long time, you may be at increased risk of DVT. Low-pressure compression stockings ("flight socks") can help to reduce your risk of DVT and fluid build-up when travelling for over eight hours.

How to put on compression stockings

Graduated compression stockings are tighter at the foot than higher up the leg. They are difficult to put on and take off so you may need someone to help you with this. You will need to:

insert your hand into the stocking as far as the heel pocket and turn the stocking inside out
carefully slip your foot into the foot portion and ease the stocking over your heel - make sure your heel is centred in the heel pocket
bring the rest of the stocking over your heel and up around your ankle and calf - don't pull the stocking, instead use the palms of your hands to gently massage the stocking up your leg

There are different lengths of compression stockings that fit your leg differently.

Knee-high stockings - these should sit below your knee.
Thigh-high stockings - bring the stocking over on to your thigh until the stocking border rests below your buttocks.
Waist-high stockings - bring the body part of your stockings up to your waist making sure the seams run vertically up the front of the garment.

Caring for your compression stockings

You may need to wear your stockings for several weeks so it's important that you take care of them and wash them regularly. You may be given a spare set to wear while washing the first set.

Always ask your doctor or nurse for advice and follow the manufacturer's instructions that come with your compression stockings.

Typical care instructions are:

machine or hand-wash using warm water, at a maximum of 40°C, every two to three days
don't wring the stockings as this action can damage their effectiveness
don't tumble-dry the stockings as the heat may damage the elastic

You should:

smooth out any creases and never roll down your stockings while wearing them - this can affect their performance and may restrict blood flow through your legs
keep ointments, oils, lanolin and similar substances away from your stockings as they can cause the elastic to deteriorate
don't sit still or lie in bed for long periods - to help the blood flow through your legs take regular walks around the house and do gentle foot and ankle exercises when sitting down
keep your legs uncrossed when you're sitting or lying down