SEARCH · PubMed Health

Results for “Stockings, Compression”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 559 records · Page 31Linked to original sources

PubMed1989

Prevention of venous thromboembolism.

The aim of prophylaxis in venous thromboembolism is firstly to prevent fatal pulmonary embolism and secondly to reduce the morbidity associated with deep vein thrombosis and the post-phlebitic limb. Particularly high-risk groups are identifiable and include those over 60 years of age undergoing major surgery, patients with malignancy and those undergoing hip operations. Low-dose subcutaneous heparin (5000 U s.c. commenced two hours preoperatively and continued eight to twelve hourly until the patient is fully mobile) is unequivocally effective in preventing deep vein thrombosis in medical and surgical patients and, most importantly, significantly reduces the incidence of fatal postoperative pulmonary embolism and total mortality. Furthermore, in established deep vein thrombosis, low-dose heparin limits proximal clot propagation, which is the prelude to pulmonary embolism. Despite this, surveys have demonstrated an alarming deficiency amongst clinicians in the application of measures to prevent venous thromboembolism. Heparin prophylaxis carries a small risk of increased bleeding complications, mostly evidenced by the frequency of wound haematoma rather than major haemorrhage. Low molecular heparin fragments (e.g. Fragmin, Choay, Enoxaprin) are now emerging as useful alternative agents, having the advantage of once daily administration and yet providing similar efficacy in the prevention of deep vein thrombosis. However, protection against fatal pulmonary embolism has yet to be demonstrated. Mechanical methods of prophylaxis designed to counteract venous stasis, such as graduated elastic compression stockings, are also beneficial in protection against deep vein thrombosis but by themselves do not achieve such consistently good prophylaxis as low-dose heparin. However, clinical trials with combinations of mechanical methods and low-dose heparin indicate that this may be the optimum approach to very high-risk patients. In the presence of established acute deep vein thrombosis, anticoagulant therapy is the mainstay in preventing pulmonary embolism. Vena caval interruption procedures should be reserved for patients in whom anticoagulation is contraindicated or for those who develop recurrent pulmonary embolism despite adequate anticoagulation.

Humans↗

PubMed1989

Suction lipectomy in the management of limb lymphedema.

We have been pleased overall with the results achieved using suction lipectomy in lymphedema patients. In appropriately selected patients, it is predictable and well-tolerated. It is, however, only palliative and temporary. It may be performed on a periodic basis. Compressive stockings are essential for success. Based on our experiences, we recommend suction lipectomy for mild temporary cases, specifically involving the upper extremity, and liposuction plus excisional debulking for more severe cases and for the lower extremity.

Adolescent↗

PubMed1989

Prevention of deep venous thrombosis following total hip replacement, using epidural analgesia.

Fifty-five patients undergoing total hip replacement using epidural analgesia were allocated to the combination of low dose heparin and dihydroergotamine (5.000 IU heparin and 0.5 mg dihydroergotamine given subcutaneously every twelve hours) (n = 27) or to placebo (n = 28). All patients wore thigh-length graded compression stockings. The patients were screened for deep venous thrombosis by means of the 99mTc-plasmin test and the diagnosis of deep-vein thrombosis was confirmed by ascending phlebography. Three patients in each group developed unilateral deep-venous thrombosis. One patient in each group developed non-fatal pulmonary embolism.

Aged↗

PubMed1988

[Conservative treatment of chronic venous insufficiency of the legs (I)].

Surgical treatment is applied to something between five and ten per cent of all patients with chronic venous diseases. Conservative treatment has proved to be justified for decompensated forms with venolymphatic insufficiency. Compression dressing is the mainstay of all measures of conservative treatment. Sufficiently high and high-stability working pressure is of decisive importance to its effectiveness. This requirement can be met best by Unna's paste dressing. The compression stocking is suitable for after-care and to a lesser extent for prophylaxis.

Clothing↗

PubMed1987

Effect of commercially available pantyhose on venous return in the lower extremity.

Although compression stockings have long been recognized as a physiologically significant tool for the promotion of venous return from the lower extremity, the role of nonprescription, commercially available support hose has not been assessed in this regard. The present study involved 100 consecutive women with no known prior history of vascular disease, who responded to an advertisement for free evaluation of the venous status of their legs. The subjects, all of whom wore commercial support hose routinely, were screened for the presence of venous disease by means of Doppler ultrasonography, phleborheography, and a detailed history focusing on risk factors and unrecognized symptoms of venous disease. Photoplethysmography (PPG) was then used to evaluate the efficiency of venous return from the lower extremity with and without the support hose in place. Worsening of PPG results occurred in 43% of the women with commercial stockings in place, whereas 23% improved and 34% showed no change. Women 50 years of age and older had a somewhat higher tendency toward poorer PPG results while wearing the support hose. Furthermore, measurements in women who showed evidence of venous disease by an abnormality in one or more of the screening tests were significantly different from the overall group (p = 0.025): 61% exhibited worsening of PPG results when wearing stockings, only 14% showed improvement, and 25% were unchanged. These results suggest that the use of a commercial support hose may be particularly deleterious to older women and is contraindicated in those with evidence of venous disease in the lower extremity.

Adult↗

PubMed1988

Hypogastric vein ligation during oncologic surgery as thromboembolic disease prevention.

Pulmonary embolism and vein thrombosis are frequent and dangerous complications in pelvic surgery. They can be the cause of death in 0.01%-0.87%. The Authors have used, since 1973, as vein thrombosis prophilaxis (VTP): early mobilization, physiotherapy, elastic compressive stocking plus pharmacologic therapy. Since 1975, according to Heidrich and Thomas researches, they have also adopted hypogastric vein ligation (HVL) in high risk patients, because those Authors underlined a primitive responsibility of the hypogastric district (mainly the left one). The Authors mortality rate after the introduction of HVL seemed very low. However, since Jan. '86, they have divided the high risk patients in 3 group (R), in order to collect statistically significant data in the usefulness of the proposed technique.

Humans↗

PubMed1985

Prevention and treatment of venous ulceration.

Venous ulcers are related to incompetence of the direct calf and ankle perforating veins, the majority of which follow deep vein thrombosis. Prevention of the latter by intravenous micro-dose heparin (1 unit/kg/hour) is effective, safe and inexpensive. Its efficacy has been proved in two controlled clinical trials. Venous ulcers have been treated by perforating vein ligation, with saphenous ligation and stripping where necessary, and with the addition of permanent knee-length elastic compression stockings in patients with femoro-popliteal incompetence. This regimen has achieved a 92% long-term success rate in patients without rheumatoid arthritis.

Clinical Trials as Topic↗

PubMed1985

[Treatment of edema with special reference to lymph drainage therapy].

Depending on its genesis, edema must be treated by medication or diet. Simultaneous application of lymph drainage may be beneficial in some cases, especially in combined edema. In some kinds of edema, in particular lymphedema, only therapeutic lymph drainage introduced into medicine by Asdonk can attain an improvement in combination with compression stockings, since there is no drug which acts on the lymphatic system. The use of digitalis and diuretics is not justified in lymphedema. Surgical techniques have not been completely convincing so far.

Clothing↗

PubMed1980

[Compression therapy of lymphedema (author's transl)].

In spite of the development of micro-surgical techniques which enable functioning lymphovenous anastomoses to be formed, surgical interventions are not usually indicated in extremities with lymphedema which are for the most part already irreparably damaged. For want of an effective medicinal alternative compression therapy is still the method of choice. Its mode of action, indication and performance are dealt with. The "manual lymph drainage" which has received much propaganda in recent years shows good results only in the initial stages which are still reversible. In pronounced indurative scleredermas a considerable reduction in volume can be achieved by wrapping the extremity in non-elastic or tubular bandages which must be consistently preserved by compression stockings of class 3 and 4.

Clothing↗

PubMed1983

Efficacy of graded elastic compression in the lower leg.

Graded elastic compression stockings on the lower leg were evaluated for their ability to (1) decrease leg volume, (2) decrease circumference, and (3) alleviate discomfort. One hundred three test subjects participated in this study, including 30 normal, asymptomatic control subjects. The conditions of the 73 symptomatic patients were categorized by pain and swelling, varicose veins, venous stasis, lymphedema, and phlebitis, which constituted symptoms in 120 legs. Although total body weight did not change during the week of observation, the volume, circumference, and pain decreased in the symptomatic group. The volume of the stockinged leg decreased in comparison with the nonstockinged control leg in the asymptomatic subjects as well. We conclude that non-custom-made graded elastic stockings with 24 mm Hg of pressure at the ankle are effective in decreasing volume, circumference, and symptoms in the lower leg in patients with minimal problems during a one-week period.

Ankle↗

PubMedDate not supplied

Large leg of superficial venous stasis, excluding disorders of the deep venous circulation.

Any abnormal increase in the volume of a lower member may be defined as "swollen leg", whether it is general and segmentary, or partial and local. This work concentrates on swollen legs caused by primary varicose disorders and does not deal with obstructions in the deep venous trunks. Swollen leg due to varicose disorder is marked by huge varices in clusters with total avalvulation. This constitutes a "phantom" swollen leg, for the evidence disappears when the patient lies down. It usually involves the long saphenous vein. It can be treated efficiently by surgery or sclerotherapy. Swollen leg of chronic venous stasis is due to vesperal oedema of complex character. Saphena insufficiency is to be observed, sometimes of the long saphenous vein, but usually of the saphena parva. Eventually large leg becomes permanent. Diagnosis is often difficult in swollen legs of deep venous stasis, and required venous functional investigations. Acute and painful forms may closely resemble ambulatory phlebitis. In all cases, lymphoedema ought to be considered, and the bruise test is conclusive. Sclerotherapy of the dilated saphenous trunks is often enough. Elastic stocking compression is sometimes necessary in order to obtain the best results, in conjunction with phlebotonics and crenotherapy. Swollen, inflammed legs are of two types: --Superficial thromboses, whether varicose or not, may be revelatory of underlying thromboembolic, cancerous, or hemopathic disease. This is the case for ascending phlebitis of the great saphenous vein which carries the risk of embolus, hyperuricemia, and, in the most localized forms, a risk of focal infection. --Phlebitis of the small saphenous vein, while rare, may be mistakenly taken to be deep lep phlebitis. The swollen legs seen in varicose trophic disorders are characterized by infectious or inflammatory edema, hypodermitis, and often, an ulcer. They may take on all of the clinical aspects of post-phlebitic disease, but functional vein studies will demonstrate patency of deep vein trunks. Active treatment and careful follow-up of venous and tissular lesions as well as suppression of aggravating factors should result in healing.

Diagnosis, Differential↗

PubMed1994

[Surgical therapy of ulcus cruris. Significance of extension of the damage to deep veins for incidence of ulcus cruris recurrence].

2 retrospective studies illustrate the importance of the extent of damage to the deep venous system governing the recurrence rate of stasis ulcers treated surgically. 1. In patients with recurrent venous stasis ulcerations associated with superficial varicosis of the great or lesser saphenous veins and incompetent perforators operative treatment of the varicose veins resulted in a 100% long-term healing rate of the ulcerations (5-year results). This was the case for 25 legs with venous ulcers in 229 consecutive cases operated for varicose veins. 2. In 76 patients with rebellious ulcers presenting without operable superficial varicose veins the treatment was a localized one consisting of wide and deep excision of the ulcer with ligature of underlying perforators and surrounding varicose veins. The 2-year success rate was 87% in 39 patients with intact deep veins, but only 59% in 37 patients with postphebite damage to the deep veins (p < 0.05). For 1 and 2 level deep vein disease the success rate was still high at 80%, but fell to 20% if damage to the deep veins extended to 3 or 4 levels! Thus, the degree of damage to the deep veins correlates well with the propensity to recurrence of venous ulceration following surgical treatment. Venous hypertension measured by phlebodynometry is the single most powerful predictor of success or failure of surgical treatment. Patients at risk should therefore be encouraged to wear compression stockings or hosiery to offset recurrencies.

Follow-Up Studies↗

PubMed1994

Routine postoperative duplex ultrasonography screening and monitoring for the detection of deep vein thrombosis. A survey of 110 total hip arthroplasties.

The use of duplex ultrasonography for routine noninvasive screening, monitoring, and management of deep venous thrombosis after total hip arthroplasty was evaluated. The reliability of duplex ultrasonography for detection of deep vein thrombosis was confirmed in an initial cohort of 51 total hip arthroplasty patients (102 lower extremities), demonstrating 91% sensitivity, 98% specificity, and 97% accuracy when compared with venography. A second cohort of 110 total hip arthroplasty patients using pneumatic compression stockings and aspirin as deep vein thrombosis prophylaxis underwent screening duplex ultrasonography of both lower extremities on postoperative Day 4. Duplex ultrasonography screening showed 10 (9.1%) patients with proximal deep vein thrombosis and 10 (9.1%) with distal deep vein thrombosis, all of whom were asymptomatic. The 10 patients with proximal deep vein thrombosis on duplex ultrasonography were prescribed therapeutic anticoagulation. Duplex ultrasonography subsequently confirmed resolution of proximal deep vein thrombosis in these patients before discontinuation of anticoagulation; none developed symptomatic pulmonary embolism through 12-month clinical followup. The 10 patients with distal deep vein thrombosis diagnosed by duplex ultrasonography were not treated with anticoagulation, but were monitored by serial duplex ultrasonography through postoperative Day 14 for propagation of distal to proximal deep vein thrombosis; none manifested symptomatic deep vein thrombosis or pulmonary embolism through 12-month clinical followup. The 90 patients with negative duplex ultrasonography results were followed clinically; 3 developed late symptomatic proximal deep vein thrombosis (1 of these later manifested pulmonary embolism). Therefore, duplex ultrasonography was used after total hip arthroplasty for the following: (1) to screen routinely in the hospital for asymptomatic proximal and distal deep vein thrombosis; (2) to monitor for potential propagation of distal to proximal deep vein thrombosis; (3) to minimize exposure to therapeutic anticoagulation by confirming the absence of proximal deep vein thrombosis in 97 of 110 patients; and (4) to demonstrate the effectiveness of mechanical and systemic deep vein thrombosis management by confirming the absence or resolution of deep vein thrombosis in all 110 patients.

Anticoagulants↗

PubMed1994

Prophylaxis against deep-vein thrombosis in total hip replacement. Comparison of heparin and foot impulse pump.

We performed a randomised controlled study to compare heparin with the A-V Impulse System in the prevention of deep-vein thrombosis (DVT) in 132 consecutive patients undergoing total hip replacement. After the operation, all patients had compression stockings, 65 were treated with calcium heparin and 67 with the intermittent plantar pump. DVT was diagnosed by Doppler ultrasound and thermography, followed by phlebography. There were 23 cases of DVT (35.4%) in the heparin group, with 16 major and seven minor thromboses. In the impulse pump group there were nine cases (13.4%) with three major and six minor thromboses. The differences for all thromboses and for major thromboses were both significant at p < 0.005. In the heparin group there was one fatal pulmonary embolism and nine patients (13.8%) had excessive bleeding or wound haematomas, as against none in the impulse pump group.

Aged↗

PubMed1994

The development in attitudes towards thromboprophylaxis in Danish surgical departments during a ten year period.

OBJECTIVE: To summarize and evaluate the progress in the current practices of thromboprophylaxis (TP) in Danish surgical departments. DESIGN: Summary of three questionnaire surveys in 1981, 1985 and 1990. SUBJECTS/SETTING: Hospital departments performing general, orthopaedic or gynaecological surgery in Denmark. MAIN OUTCOME MEASURES: Development or routine employment of TP, standard instructions for TP, indications and methods for TP. RESULTS: Replies were obtained from 85%-92%. During the period the overall use TP increased from 89% of the departments in 1981 to 93% in 1985 to 96% in 1990 (p = 0.03). The use of TP according to standard instructions increased from 50% over 54% to 68% (p = 0.001). Heparin is the drug of choice in 95% and graded compression stockings in 70% of the departments. Only 36% of the departments routinely use TP in emergency surgery. CONCLUSIONS: The development in attitudes towards TP in Denmark complies with the scientific evolution. Methods and indications correspond with the recommendation of the literature and international consensus conferences. However, the low rate of TP in emergency surgery is unsatisfactory, and the use of acetylsalicylic acid as postoperative venous thromboprophylaxis should stop. The authors emphasize the introduction of firm standard instruction for TP in all surgical department. A continuous evaluation of the use of TP in Danish surgical department by means of quality assurance studies is recommended.

Denmark↗

PubMed1994

[Essential varicose veins and chronic venous insufficiency].

Chronic venous insufficiency of the lower limbs has varied expressions: purely functional disorders, varicose veins, varicosities, oedema and trophic cutaneous disorders. For a given individual, these aspects are not necessarily increasing stages of severity of the same disease. On the other hand, many associations are possible; they are determined by the mechanism and the degree of chronic venous insufficiency, as well as by the clinical situation in which they develop. Work-up is based on careful clinical examination. Doppler examination and echography are useful for varices if radical treatment is considered. Ultrasound examination is required in case of cutaneous ulcer in order not to mistake a varicose ulcer for a trophic disorder due to incontinence of deep venous trunks, most often of thrombotic origin. Varicose veins can become complicated. Varicose haemorrhage requires immediate treatment by compression. Superficial phlebitis needs doppler examination and echography because it can be associated to deep venous thrombosis. With regard to varices and chronic venous insufficiency, treatment varies according to the concerns of the patients. Elastic compression stockings are useful whatever the clinical expression of the disease. "Phlebotropic" drugs can be used whenever venous insufficiency is associated with functional symptoms. The use of radical treatment, whether sclerosing injections or surgery, depends on anatomic lesions, the degree of venous incontinence and the severity of symptoms, but also on the desires of the patients, fully informed as to the advantages and the limitations of each technique. Personalized treatment is thus possible.

Chronic Disease↗

PubMed1993

Evidence of venous stasis after abdominal insufflation for laparoscopic cholecystectomy.

Intraoperative venous stasis may increase the risk for perioperative deep vein thrombosis and pulmonary embolism. To determine if abdominal insufflation during laparoscopic cholecystectomy causes venous stasis, eight patients undergoing this procedure had their left common femoral veins examined by a duplex scanner before and after abdominal insufflation; the veins then were examined again before and after deflation. The right femoral veins were catheterized to measure femoral venous pressures. Abdominal insufflation to 14 millimeters of mercury pressure increased femoral venous pressures (10.2 +/- 4.1 millimeters of mercury to 18.2 +/- 5.1 millimeters of mercury; p < 0.001) and slowed peak blood velocities (24.9 +/- 8.5 centimeters per second to 18.5 +/- 4.5 centimeters per second; p < 0.05) without changing the cross-sectional areas (1.1 +/- 0.4 centimeter squared to 1.2 +/- 1.5 centimeter squared; p = NS) of the common femoral veins. Insufflation also reduced or eliminated pulsatility in the common femoral veins in 75 percent of the patients, indicating that insufflation was causing partial proximal venous obstruction. After 80 +/- 21 minutes of surgery, these changes remained significant. Deflation of the abdomen restored normal venous pulsatility in all patients, reduced femoral venous pressures (18.5 +/- 5.2 millimeters of mercury to 12.2 +/- 9.8 millimeters of mercury; p < 0.001), increased the peak blood velocities (14.2 +/- 6.8 centimeters per second to 28.1 +/- 16 centimeters per second; p < 0.05) and decreased the cross-sectional areas (1.4 +/- 0.6 centimeters squared to 0.9 +/- 0.4 centimeters squared; p < 0.05) of the common femoral veins, indicating venous decompression had occurred. The results suggest abdominal insufflation causes venous stasis during laparoscopic cholecystectomies. Measures shown to reduce intraoperative venous stasis, such as pneumatic compressive stockings, may benefit patients undergoing these procedures.

Adult↗

PubMed1996

The incidence of deep venous thrombosis after laparoscopic cholecystectomy.

OBJECTIVE: To determine the incidence of deep venous thrombosis (DVT) after laparoscopic cholecystectomy. DESIGN: Prospective cross-sectional analysis, with a one-month follow-up, conducted in 1994. SETTING: University teaching hospital. SUBJECTS: 20 patients undergoing elective or urgent laparoscopic cholecystectomy, consecutively recruited. INTERVENTIONS: Patients received thromboprophylaxis according to the normal practice of the attending surgeon and underwent laparoscopic cholecystectomy. A venous duplex scan was performed before the operation and on Day 1, 7 and 30 after the operation. MAIN OUTCOME MEASURE: The presence of postoperative DVT. RESULTS: All patients were given graduated compression stockings to wear and 16 received electrical stimulation of the calf during the operation. Only 16 patients received pharmacological thromboprophylaxis before the operation, but all patients received this after the operation. The median duration of pneumoperitoneum was 80 minutes (40-160 minutes). Eleven of 19 patients completing all the required scans developed venous thrombosis (incidence, 55%); in three the thromboses involved major axial veins. In one patient the Day 7 and Day 30 scans were not performed, but the Day 1 scan was negative. Seven of the 11 thromboses were detected on the Day 1 scan. None of the DVTs were suspected clinically. CONCLUSIONS: This extremely high incidence of venous thrombosis correlates with the haemodynamic changes which occur in the venous system during pneumoperitoneum. Laparoscopic cholecystectomy should not be considered a procedure with a low risk of DVT, and further studies are needed to determine optimal DVT prophylaxis for laparoscopic surgery.

Adult↗