Phlebologie 2016; 45(01): 25-28
DOI: 10.12687/phleb2287-1-2016
Original Article
Schattauer GmbH

Light medical compression stockings reduce symptoms when standing equally well as firm ones

Article in several languages: English | deutsch
W. Blättler
1   Consultant für Phlebologie„ Wädenswil, Switzerland
,
H.-J. Thomä
2   Medizinisch-Wissenschaft. Abteilung Bauerfeind AG, Zeulenroda, Germany
,
C. Winkler
2   Medizinisch-Wissenschaft. Abteilung Bauerfeind AG, Zeulenroda, Germany
,
F. Amsler
3   Amsler Consulting, Basel, Switzerland
› Author Affiliations
Further Information

Publication History

Received: 01 October 2015

Accepted after Revision: 05 November 2015

Publication Date:
21 December 2017 (online)

Summary

Background In Germany, therapy with medical compression stockings (MCS) relies almost completely on stockings exerting an ankle pressure of 23-32 mmHg. There is, however, strong evidence that MCS exerting a pressure <20 mmHg are at least as effective offering great advantages in use.

Methods We expanded prolonged standing to a stress test. The lower leg volume increase was monitored and, in parallel, the emergence of symptoms. Twenty-four healthy volunteers experienced symptoms in an initial test with bare legs and were therefore asked to take further tests with low (18-21 mmHg, D1) and high pressure (23-32 mmHg, D2) MCS. Leg volume was assessed with the Bodytronic 600 and symptoms with a numeric rating scale (1-10).

Results Lower leg volume increased with no MCS to 22 ml after 2 min and to 44 ml after 10 min. D1 reduced the volume increase in the second phase only, by 16 ml (p=0.020), D2 in the first phase already, by 9 ml (p=0.006), and by 22 ml (p<0.001) after 10 min. Symptoms increased continuously to 2.93 scale points. The various symptoms were equally reduced by either stocking.

Conclusions Prolonged standing leads to leg volume increase and symptoms. We found neither a cause-and-effect relationship between volume increase and symptoms nor between compression strength or volume increase prevention and symptoms.

 
  • References

  • 1 Gerlach H, Amsler F. Geschlechtsspezifische Unterschiede bei der Verordnung von medizinischen Kompressionsstrümpfen. Vasomed 2014; 26: 2-10.
  • 2 Wienert V, Gerlach HE, Gallenkemper G, Kahle M. et al. Leitlinie Medizinischer Kompressionsstrumpf. Phlebologie 2006; 35: 315-320.
  • 3 Rabe E, Pannier-Fischer F, Bromen K, Schuldt K. et al. Bonner Venenstudie der Deutschen Gesellschaft für Phlebologie. Phlebologie 2003; 32: 1-14.
  • 4 Strölin A, Volkert B, Häfner HM, Jünger M. Medizinische Kompressionsstrümpfe bei CVI-Patienten. Einfluss auf die Lebensqualität und venöse Hämodynamik. Phlebologie 2005; 34: 34-41.
  • 5 Amsler F, Blättler W. Compression therapy for occupational leg symptoms and chronic venous disorders - a meta-analysis of randomized controlled trials. Eur J Vasc Endovasc Surg 2008; 35: 366-372.
  • 6 Pannier F, Rabe E. Optoelectronic volume measurements to demonstrate volume changes in the lower extremities during orthostasis. Int Angiol 2010; 29: 395-400.
  • 7 Engelberger RP, Keo HK, Blaettler W, Fahrni J. et al. The impact of orthostatic challenge on arteriovenous hemodynamics and volume changes of the lower extremities. J Vasc Surg 2013; 01: 250-256.
  • 8 Tischer T, Oye S, Wolf A, Feldhege F. et al. Reliability of a novel optical 3D volumetric measurement system for assessing lower limb circumference and volume. Submitted..
  • 9 Widmer LK, Wandeler JM. Leg complaints and peripheral venous disorders. In: Widmer LK. ed. Peripheral venous disorders (Basle Study III). Bern: Hans Huber; 1978: 33-42.
  • 10 Langer RD, Ho E, Denenberg Jo, Fronek A, Allison M, Criqui MH. Relationships between symptoms and venous disease. Arch Int Med 2005; 165: 1420-1424.
  • 11 Carpentier P, Poulain C, Fabry R, Chleir F. et al. The Venous Working Group of the Société Française de Médecine Vasculaire. Ascribing leg symptoms to chronic venous disorders: the construction of a diagnostic score. J Vasc Surg 2007; 46: 991-996.
  • 12 Duque M, Yosipovitch G, Chan YH, Smith R, Levy P. Itch, pain, and burning sensation are common symptoms in mild to moderate chronic venous insufficiency with an impact on quality of life. J Am Acad Dermatol 2005; 53: 504-508.
  • 13 Amsler F, Rabe E, Blättler W. Leg symptoms of somatic, psychic, and unexplained origin in the population-based Bonn Vein Study. Eur J Vasc Endovasc Surg 2013; 46: 255-262.
  • 14 Blazek C, Amsler F, Blättler W, Keo HH, Baumgartner I, Willenberg T. Compression hosiery for occupational leg symptoms and leg volume: a randomized crossover trial in a cohort of hairdressers. Phlebology 2013; 28: 239-247.
  • 15 Boisseau MR, Chardonneaux JM. Terms and objectives of the Société Française de Phlébologie commission on C0s-C1s. Phlébologie 2010; 63: 58-64.
  • 16 Damasio AR. Self comes to mind. Vintage 2012. Making maps and making images. 63ff.
  • 17 Steinberg BE, Tracey KJ, Slutsky AS. Bacteria and the neural code. NEJM 2014; 371: 2131-2133.
  • 18 Damasio AR. Self comes to mind. Vintage, 2012. The origins of homeostasis. 43ff the body in mind, 89ff.