Proper use of compression stockings

  Varicose veins of the lower extremities are a common disease, which refers to the elongated, winding and varicose state of the superficial venous system of the lower extremities. In Ming Dynasty, “The Authentic Book of Surgery” contains: “tendon tumor, firm and purple in color, the base of green tendons, coiled even, knotted like earthworms”, which refers to varicose veins.  As we know, blood vessel is the transport channel in human body, because the heart keeps beating, the arterial blood vessels send the blood rich in oxygen and nutrition to all parts of the body continuously, and the venous blood vessels return the blood to the heart after releasing oxygen and nutrition. The lower limb venous system is responsible for recycling the blood in the legs, in order to make the blood flow upward and not backward, there are many valves in the veins of the lower limbs similar to the partitions of the waterwheel in rural China, if the valves are damaged, the blood flow back to the legs is affected and varicose veins or leg swelling will occur. Congenital weakness of the vein walls, venous valve insufficiency and increased pressure within the superficial veins are the main causes of superficial varicose veins. Varicose veins of lower extremities are divided into two categories: simple and secondary, the former refers to the lesion of superficial veins themselves without deep vein lesions; the latter refers to the consequences of deep vein thrombosis or deep vein valve insufficiency.  Because the human body does not have the mechanism of self-repairing valves, so varicose veins are an irreversible phenomenon. According to statistics, about 25-40% of women and 20% of men have this phenomenon. Teachers, surgeons, nurses, hair stylists, counter girls, chefs, restaurant waiters and other occupations that require long periods of standing are all at high risk. In addition, varicose veins are also associated with genetics, oral contraceptives and pregnancy. In addition to affecting the aesthetics of the legs, varicose veins are also known to be more painful at night and lighter in the morning; later on, the number of prominent veins increases and the expansion of varicose veins becomes obvious, with the saphenous vein in the calf being the most important. Severe varicose veins can cause inflammation, ulceration, bleeding, foot edema and nocturnal cramps on the skin surface. Longer duration of the disease often results in skin atrophy, flaking, itching, hyperpigmentation, hardening of the skin and subcutaneous tissue, and even eczema and ulcer formation, sometimes complicated by bleeding and thrombophlebitis.  Taking medicine cannot cure varicose veins, and internal and external medicines hardly work. There are three types of treatments for varicose veins in the lower extremities, including compression therapy, varicose vein sclerotherapy and surgery. Wearing medical elastic stockings is the most effective method of compression therapy. Compression therapy will have a direct mechanical effect on the normal pressure of the diseased vein by normalizing the transmural pressure of the vein, which is always higher than 30 mmH2O during the course of chronic venous disease, regardless of the cause. Of course, compression stockings do not cure varicose veins, but five types of medical compression stockings were compared with a placebo pantyhose in a double-blind controlled randomized trial of 32 women in occupations with prolonged standing positions.  The intensity of the test subjects’ complaints (heaviness in the legs, pain, swelling) was assessed within an analogous range, and the results showed that there was a significant reduction in complaints among those using the various medical compression stockings, while no reduction was seen in those using the placebo pantyhose (p<0.0001). This is strong evidence that it acts as an allopathic treatment to prevent the exacerbation of varicose veins, to reduce patients' symptoms, and as an adjunct to other therapies. When varicose veins are serious to a certain extent, discomfort increases, or complications such as phlebitis and hyperpigmentation appear, doctors still recommend patients to undergo early surgical treatment to avoid further aggravation of the condition and affect the quality of life.  The choice of elastic stockings Nowadays, there are more channels to buy medical elastic stockings, but the doctor reminds varicose vein patients that it is better to go to the vascular surgery department of the regular hospital to get a prescription from the doctor. The doctor will choose the right compression stockings according to the degree of varicose. If the varicose veins have extended to the thighs, elastic stockings for long legs may be worn. If they have not progressed to the thighs, elastic stockings below the knee joint are usually sufficient. Medical compression stockings establish the highest support pressure at the ankle and gradually decrease up the leg. It decreases to 70-90% of the maximum pressure in the calf and 25-45% of the maximum pressure in the thigh. This decreasing change in pressure allows the venous blood to flow back to the lower extremities, effectively relieving or improving the pressure on the veins and valves of the lower extremities.  Elastic stockings are divided into the following levels of pressure: the first level of low-pressure prevention type (20-25mmHg): for the prevention of varicose veins, thrombosis of the health care of people with a high incidence; the first level of medium pressure treatment type (25-30mmHg): for patients at the beginning of varicose veins; the second level of high-pressure treatment type (30-40mmHg): for patients who already have obvious varicose veins in the lower limbs and accompanied by discomfort in the legs (such as lower limb soreness, weakness, swelling and pain, eczema, cramping and numbness, pigmentation, etc.), phlebitis, severe varicose veins during pregnancy, patients after varicose vein stripping of large and small saphenous veins, patients with post-deep vein thrombosis syndrome; tertiary high-pressure treatment type (40-50 mmHg): for patients with highly swollen lower limbs, ulcers, darkened and hardened skin, irreversible lymphedema, etc. The elastic stockings are divided into small size S, medium size M, large size L, and large size XL. The three main sizes (cm) of the wearer's legs are measured with a soft ruler: the circumference of the ankle (the thinnest part of the neck), the maximum circumference of the calf belly and the maximum circumference of the thigh, in order to determine the appropriate number.  The consensus view is that wearing medical compression stockings is the basic treatment for all chronic venous insufficiency diseases and the main method of preventing post-venous thrombosis syndrome. The aim is to reduce the functional symptoms of chronic venous disease, to reduce edema, to control the progression of varicose veins and to try to limit complications such as nutritional disorders. The main functions of medical elastic stockings are: restoration of the function of the veins of the lower limbs after surgery, prevention of the recurrence of varicose veins; elimination of edema after various surgeries, promotion of wound healing; elimination of swelling and soreness caused by varicose veins and obstruction of blood return to the veins of the lower limbs, gradual improvement of the blackened and hardened skin, healing of the ulcerated skin, restoration of the original state of the tortuous veins whose varicose degree has become light; prevention of the formation of deep vein thrombosis in the lower limbs of patients who are bedridden for a long time. Deep vein thrombosis; eliminate lower limb edema of pregnant women in late pregnancy, prevent lower limb varicose veins and deep vein thrombosis of women after delivery; prevent economy class syndrome of air travelers; prevent lower limb varicose veins by reducing lower limb soreness and discomfort for long time standing, sitting and heavy physical laborers.  Medical elastic stockings for people: long time standing people: teachers, traffic police, shopping guide, beauticians, doctors, nurses, etc.; long time sitting people: IT people, white-collar workers, civil servants and other office workers long time standing or sitting: due to muscle fatigue and gravity, resulting in poor blood flow back to the legs, blood viscosity increases leading to lower limb venous disease; pregnant women, long-term use of contraceptives when the body of pregnant people Hormonal changes, blood volume increased by more than 20%; the fetus and the enlarged uterus compress the pelvic veins and iliac veins, the weight increase during pregnancy, the increase in venous pressure in the legs, resulting in poor blood return, resulting in lower limb venous disease; frequent business trips, airplanes, long-distance car people, flight attendants usually called economy class syndrome, due to the weightlessness at high altitude, resulting in poor blood return in the legs, resulting in lower limb venous disease, serious Obese people have high cholesterol and lipid in blood, increase blood viscosity, and high weight makes it difficult for venous blood to return to the heart, leading to lower limb venous disease; people who have already suffered from lower limb venous disease, because the veins are already in the disease state, must be improved through treatment, otherwise the disease will continue to develop; people with high incidence of lower limb deep vein thrombosis, patients after major surgery, patients with malignant tumors, hemiplegic Patients, women in late pregnancy and maternity, patients with lower limb fracture, patients with serious infection, elderly people, etc.  The best time to wear compression stockings is in the morning when you wake up, when the vascular system of the legs is at its maximum function and swelling has not yet occurred. Put one hand into the sock, pinch the sock two inches inside the head, and with the other hand, turn the sock to the heel. Turn most of the sock over and smooth it out so that the foot can easily fit into the toe of the sock. Brace your thumbs on the inside of the sock, grasp the body of the sock with your four fingers, put your foot inside the sock, brace your thumbs outward and pull the sock toward your ankle with your four fingers and thumbs, and place the heel of the sock in the correct position. Turn the sock leg back and pull it upward in order, and put it on and flatten it against your body. Medical compression stockings have a therapeutic pressure, and the pressure varies from one area to another, so the compression stockings commonly worn by women are not a substitute.  Because of the high pressure, it is recommended that patients take off their stockings before going to bed to rest. Take special care not to scratch the stockings with diamonds or long nails when putting on or taking off the stockings. Please cut your fingernails regularly and prevent skin cracking on your heels during the dry season to avoid scratching your stockings. In addition, you should always check the inside of your shoes to prevent unnecessary wear and tear caused by debris, and to prolong the life of your stockings. Elastic socks also need to be cleaned regularly, especially for patients who sweat. Wash them in warm water with a neutral detergent, do not wring them out, squeeze them by hand or use a dry towel to absorb excess water, and dry them in a cool place, not in the sun or under artificial heat sources. Any high quality product can only be used with care and attention to prolong its life and achieve the best results.  Medical compression stockings are not suitable for all people with varicose veins: skin infections such as: boils, abscesses, deep abscesses, dermatitis, etc., cardiac insufficiency loss, progressive diabetic microvascular disease patients are not suitable for compression stockings, and medical compression stockings should never be used when the ankle-brachial index is less than 0.8. Therefore, it is recommended that people with varicose veins should visit the vascular surgery department of the hospital to receive professional advice in order to use elastic stockings correctly and reasonably.