Prevention and treatment of varicose veins with compression stockings
Varicose veins of the lower limbs are a common disease, which refers to the elongated, winding and varicose state of the superficial venous system of the lower limbs. The Ming Dynasty “Surgical Authentic” contains: “tendon tumor, firm and purple color, the base of green tendons, coiled even, knotted like earthworms”, that 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 lower limb veins similar to the partition 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. Lower limb varicose veins are divided into two categories: simple and secondary, the former refers to the lesion of the superficial vein itself without the deep vein lesion; the latter refers to the consequence of deep vein thrombosis or deep vein valve insufficiency.
Varicose veins are an irreversible phenomenon because the body does not have the mechanism to repair the valves by itself. 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, and in the later stages, the protruding veins increase in number and become more dilated and tortuous, 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, which can sometimes be complicated by bleeding and thrombophlebitis. The varicose veins cannot be cured by taking medication, and internal and external medication hardly works.
There are three types of treatments for varicose veins in the lower extremities, including
Compression therapy, varicose vein sclerotherapy and surgery are the three main types of treatment. Wearing medical compression stockings is the most effective method of compression therapy. Compression therapy has the direct mechanical effect of normalizing the transmural pressure of the diseased vein, which is always higher than 30 mmH2O during walking, regardless of the cause of the chronic venous disease. 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 (leg heaviness, 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 among 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 degree, 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.
Nowadays, there are more channels to buy medical elastic stockings, but doctors remind 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 value at the calf and 25-45% of the maximum pressure value at the thigh. This decreasing change in pressure allows venous blood flow back to the lower extremities, effectively relieving or improving the pressure on the veins and venous valves of the lower extremities.
The compression stockings are divided into the following levels of pressure.
One level of low pressure preventive type (20 to 25 mmHg): for the health care prevention of people with high incidence of varicose veins and thrombosis.
Level I medium pressure therapeutic type (25 to 30 mmHg): for patients in the early stages of varicose veins.
Secondary high-pressure treatment type (30～40mmHg): applicable to patients who already have obvious varicose veins in the lower limbs with leg discomfort (such as soreness, weakness, swelling and pain in the lower limbs, eczema, cramping and numbness, pigmentation, etc.), phlebitis, severe varicose veins during pregnancy, patients after varicose vein stripping, 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.
Elastic stockings are divided into small size S, medium size M, large size L and large size XL. The three main dimensions (cm) of the wearer’s leg 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 compression stockings are
Restoring the function of the veins of the lower extremities after surgery and preventing the recurrence of varicose veins; eliminating edema after various surgeries and promoting wound healing; eliminating swelling and soreness caused by varicose veins and impaired blood flow in the veins of the lower extremities, gradually improving the darkened and sclerotic skin, healing the ulcerated skin and restoring the tortuous veins to their original state when the varicose degree becomes lighter; preventing deep vein thrombosis in the lower extremities of patients who are bedridden for a long time; eliminating pregnancy The lower limb edema of pregnant women in late pregnancy, prevent varicose veins of lower limb and deep vein thrombosis of women after delivery; prevent the economy class syndrome of air travelers; prevent varicose veins of lower limb by reducing the discomfort of lower limb soreness and swelling for long time standing, sitting and heavy physical laborers.
Medical elastic stockings for the crowd.
Those who stand for a long time: teachers, traffic police, shopping guides, beauticians, doctors, nurses, etc.; those who sit still for a long time: IT people, white-collar workers, civil servants and other office workers – standing or sitting still for a long time: due to muscle fatigue and gravity, resulting in poor blood flow back to the legs and increased blood viscosity leading to lower limb venous disease; pregnant women Pregnant women, people who take birth control pills for a long time – when pregnant, hormonal changes in the body, blood volume increases by more than 20%; the fetus and the enlarged uterus compress the pelvic veins and iliac veins, and the weight increase during pregnancy increases the venous pressure in the legs, resulting in poor blood return, leading to lower limb venous disease; people who travel frequently, travel by airplane, long-distance bus, and Flight attendants – commonly known as economy class syndrome, due to weightlessness at high altitude, resulting in poor blood return to the legs, resulting in lower limb venous disease, and in serious cases, prone to pulmonary embolism; obese people – due to high cholesterol and lipids in the blood, increased blood viscosity, coupled with High body weight makes it difficult for venous blood to return to the heart, leading to lower extremity venous disease; people who have already suffered from lower extremity venous disease – because the veins are already in a state of disease and must be improved by treatment, otherwise the disease will continue to develop; people with high incidence of lower extremity deep vein thrombosis – -Patients after major surgery, patients with malignant tumors, patients with hemiplegia, women in late pregnancy and maternity, patients with lower limb fractures, patients with serious infections, elderly people, etc.
The best time to wear medical compression stockings
The best time to put on medical elastic stockings is in the morning when you wake up, because the vascular system of the leg is at its maximum function and swelling has not yet occurred. Put one hand into the sock and squeeze the sock two inches inside the head, and with the other hand, turn the sock to the heel. Turn the majority of the sock over and spread it smoothly so that the foot can easily reach into the toe of the sock. Brace your thumbs on the inside of the sock with both hands, grasp the body of the sock with your four fingers, and bring your foot into the sock. Brace the sock tightly with your thumbs outward with both hands, and pull the sock toward the ankle with your four fingers in coordination with your thumbs, and place the heel of the sock in the correct position. Turn the sock leg back and pull it upward in a sequential manner, and whisk the sock flat against your body after putting it on. Medical compression stockings have a therapeutic pressure and the pressure varies from part to part, so the compression stockings commonly worn by women are not a substitute. Due to 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 of compensation, patients with progressive diabetic microvascular disease are not suitable for wearing elastic stockings, and medical elastic 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 go to the vascular surgery department of the hospital to receive professional advice in order to use elastic stockings correctly and reasonably.