Venous Complications and Stockings

venous

Compression Hosiery for venous disorders

Common factors that affect or veins are:

  • Occupations that involve extended periods of standing
  • Being overweight
  • Connective tissue weakness

Development of venous problems are also encouraged by alcohol, which causes blood vessels to dilate, hormonal changes in pregnancy and those caused by medicines. The discomfort of venous problems is minor to begin with, because slight changes in the leg causes no pain. Left untreated, venous disorders can become chronic.
The most common diseases of the leg veins are:

  • Spider veins
  • Varicose veins
  • Chronic venous insufficiency
  • Deep venous thrombosis
  • Inflammation of the veins
  • Leg ulcers

With some venous problems, it is often sufficient to start wearing compression stockings in order to maintain the health of your legs. Medical compression stockings are prescribed by the doctor if required and fitted by the Medical Orthotist.

The aim of compression treatment with compression stockings is to “strengthen” the veins, to reduce venous pressure, normalise the function of the vessel wall and improve metabolic exchange in the tissues.

The compression stockings are available in different compression classes that are used depending on the severity of the disease. The basic differences are in the strength of the material. The stockings are also available in a range of sizes and lengths (determined by taking length and circumferencial measurement) and different colours. They are also available in below-the-knee and thigh lengths and can also be custom-made according to the patient’s unique requirements.

Varicose veins

Varicose veins are veins that have become enlarged and twisted. It commonly refers to the veins of the legs but can occur elsewhere in the body. Veins have leaflet valves to prevent blood from flowing backwards. Leg muscles pump the veins to return blood to the heart. When veins become varicose, the leaflets of the valves no longer meet properly, and the valves no longer work.

This allows blood to flow backwards and the valves enlarge even more. Varicose veins are most common in superficial veins of the legs, which are subject to high pressure when standing. Besides being a cosmetic problem, varicose veins can become painful, especially when standing. Severe long-standing varicose veins can lead to leg swelling, venous eczema, skin thickening and ulceration. Non-surgical treatments include sclerotherapy, elasticised compression stocking, elevating the legs and exercise. Secondary varicose veins are those developing as collateral pathways, typically after stenosis or occlusion of the deep veins, a common sequel of extensive deep venous thrombosis(DVT). Treatment options include compression stocking, occasionally sclerotherapy, and rarely limited surgery.

Lymphedema

Lymphedema is a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system. The lymphatic system returns the interstitial fluid to the thoracic duct and then to the bloodstream, where it is recirculated back to the tissues. Tissues with lymphedema are at risk of infection. Symptoms may include a feeling of heaviness or fullness, edema (swelling), and aching pain in the affected area. Treatment of lymphedema varies depending on the severity of the edema and the degree of fibrosis of the affected limb. Most people with lymphedema follow a daily regimen of treatment as suggested by their physician of certified lymphedema therapist. The most common treatments are a combination of manual compression lymphatic massage, compression garments or bandaging.

Compression Class 1

  • Light compression for light pressure at the ankle
  • Suitable for tired, heavy legs, mild variose veins and slight swelling
  • Desirable for prevention of varicose veins, e.g. in pregnancy or standing and sitting occupations
  • Used during long flights to reduce swelling and pain in legs
  • Used by athletes.
  • Specially design for specific functions

Compression Class 2

  • Moderate pressure for moderate pressure at the ankles
  • Used in e.g. severe varicose veins, legs that are often swollen, swelling following thrombosis (venous occlusion), after healing of small ulcers, in severe inflammation during pregnancy, after sclerotherapy or surgery, after superficial phlebitis

There are also contra-indications to compression therapy and these include:

  • Advanced arterial occlusive disease
  • Severe disorders of heart function
  • Weeping skin diseases
  • Severe disorders of nerve function in the arms and legs