A study published in the September American Journal of Nursing (AJN) indicates that graduated compression stockings were used incorrectly in 29 percent of the patients and sized incorrectly in 26 percent of the patients. Compression stockings play an important role in preventing the formation of deep vein clots that can result in pulmonary complications and death
“Problems with the use and sizing of graduated compression stockings are common throughout the country, and this study is one of the first to systematically analyze the problems and recommend ways to improve practice,” said Elizabeth H. Winslow, PhD, RN, FAAN, Research Consultant, Presbyterian Hospital of Dallas, Texas, and lead author of the study, in a press release. “Based on the study findings, we recommend that knee-length stockings be the standard length used and that the education of nurses and patients about the proper use of stockings be improved.”
This study and previous research has found that problems with use and size were more common with the thigh-length stockings and in overweight patients. More patients who had thigh-length stockings found them uncomfortable than did those who had knee-length stockings, and 20 percent of patients did not understand the stockings’ purpose. This lack of understanding may play a role in patients’ failure to wear them correctly.
Graduated compression stockings are not elastic support stockings. They were developed based on research that revealed the optimal amount of graded compression for promoting blood flow and reducing the risk of thrombosis. When fitted and used properly, they increase blood flow velocity, reduce the risk of venous wall dilation and intimal tear, improve venous valve function, and possibly reduce coagulability, all of which reduce the risk of venous thrombosis (a blood clot that forms in a vein).
Many studies conducted over the past three decades have shown that graduated compression stockings, used alone or in combination with other external compression devices or medications, significantly reduce the rate of deep-vein thrombosis in post-surgical patients. Research conducted in the 1980s and 1990s suggested that thigh- and knee-length compression stockings are equally effective in reducing deep-vein thrombosis, but there are few recent studies.
“A lot can be done to optimize the benefits of graduated compression stockings and minimize adverse effects,” said Debra Brosz, MSN, RN, ONC, NEA-BC, a researcher at Presbyterian Hospital of Dallas and coauthor of the study. “Knee-length stockings have many practical advantages over thigh-length in that they lower the risk of problems and healthcare costs. The improper use and sizing of these stockings and the deficiencies in patient education are important healthcare issues.”