Evaluation of the efficacy and safety of compression garments in the treatment of patients with chronic lower limb vein diseases

Aim. To evaluate clinical efficacy, safety and compliance level of outpatient application of “TONUS ELAST” compression garments in patients with chronic diseases of lower limbs of C3-C4 clinical classes according to CEAP.
Material and methods. Continuous compression therapy during 6 months with the use of “TONUS ELAST” garments was received by 34 patients (12 men and 22 women) with chronic diseases of the lower limbs of C3-C4 clinical classes. The average age was 67 ± 3.2 years. There were 26 (76%) patients with varicosity and 8 (24%) patients with postthrombophlebitic stage of different recanalization. Anamnesis duration was 16 ± 3.9 years. Dynamic analysis of subjective and objective clinical symptomatology, results of legometry, volumetry and ultrasound examination with registration of blood flow rate in the femoral vein according to the developed protocol was carried out.
Results of the study. Clinical observation in the dynamics of the study and instrumental methods of examination confirm the significant clinical efficacy of “TONUS ELAST” garments of the 2nd class of compression as a means of conservative treatment of chronic diseases of C3-C4 clinical classes. Positive dynamics of subjective symptomatology with the achievement of the most successful result in the management of convulsive (96.6%) and painful (93.8%) syndromes was revealed. Reduction of the shin circumference was recorded in 100% of observations on the left lower limb and in 96,7% on the right one. Statistically significant positive dynamics of volumetric parameters was achieved after 3 months of compression therapy. The tendency to acceleration of blood flow in the femoral vein in 71,4% of observations was revealed. Laboratory analysis of hemostasiological parameters demonstrated compensatory normocoagulation. Absence of cases of individual intolerance and adverse effects of compression products indicates their safety. A high level of adherence of patients to the therapy is registered. Doctors and patients gave a positive subjective assessment of the effectiveness and consumer properties of the studied product.
Conclusion. Compression garment “TONUS ELAST” of the 2nd class of compression can be recommended as a safe, effective and comfortable means of outpatient therapy and prevention of chronic diseases of lower limbs veins. 

1. Zhukov B. N ., Katorkin S. E ., Sizonenko Ya. V ., Kravtsov P. F. Approaches to the improvement of the efficiency of rehabilitation of patients with chronic venous insufficiency of the lower extremities. Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kul’tury = Problems of Balneology, Physiotherapy, and Exercise Therapy. 2009;(4):19–22. (In Russ.)

2. Russian Clinical Guidelines for the Diagnostics and Treatment of Chronic Venous Diseases. Flebologiya. Journal of Venous Disorders. 2018;12 (3):146–240. (In Russ.) doi: 10.17116/flebo20187031146.

3. Riebe H., Konschake W., Haase H., Jünger M. Advantages and disadvantages of graduated and inverse graduated compression hosiery in patients with chronic venous insufficiency and healthy volunteers: A prospective, mono-centric, blinded, open randomised, controlled and cross-over trial. Flebologiya. Journal of Venous Disorders. 2018;33 (1):14–26. doi: 10.1177/0268355516682885.

4. Sushkov S. A . Compressive therapy at chronic venous insufficiency. Novosti Khirurgii. 2012;20 (2):105–117. (In Russ.) Available at: http://www.surgery.by/pdf/full_text/2012_2_18_ft.pdf.

5. Bogachev V. Y ., Boldin B. V ., Rodionov S. V . Compression therapy for chronic edema of the extremities. Stacionarozameshhajushhie tehnologii: Ambulatornaja hirurgija = Ambulatory surgery: hospital-replacing technologies. 2018;(3-4):28–35. (In Russ.) doi: 10.21518/1995–1477–2018–3-4-28–35.

6. G.P. Kotelnikov, S.E. Katorkin, E.A. Korymasov. Clinical and Pathogenetic Concept of Diagnostics and Complex Treatment of Patients with Combined Pathology of Venous and Musculoskeletal Systems of the Lower Extremities. Novosti Khirurgii. 2018;26(6):677-688. doi: 10.18484/2305-0047.2018.6.677.

7. Rabe E., Partsch Y., Hafner J., Lattimer Ch., Mosti G., Neumann M., Urbanek T., Huebner M., Gaillard S., Carpentier P. Indications for medical compression stockings in venous andlymphatic disorders: An evidence-based consensus statement. Phlebology. 2018;33 (3):163–184. doi: 10.1177/0268355516689631.

8. Tsyplyashchuk A.V., Stoiko Yu.M., Kharitonova S.E., Vunder E.S., Mamadaliev D.M. Compression knitwear VENOTEKS TREND in treatment of patients with chronic venous diseases of the lower limbs. Angiology and Vascular Surgery. 2017;23 (3):167–172. Available at: http://venoteks.ru/assets/site/img/klinicheskie/Stoyko_aisx__3–2017.pdf.

9. Sapelkin S. V ., Zolotukhin I. A . Compression Therapyin the Russian Phlebological Practice (Results of the Questionnaire Study Among the Participants of the Xth Conference of the Association of Phlebologists of Russia). Flebologiya. Journal of Venous Disorders. 2015;9 (3):4–10. (In Russ.) doi: 10.17116/flebo2015934–10.

10. Damstra R. J., Partsch H. Prospective, randomised controlled trial comparing the effectiveness of adjustable compression VELCRO ® wraps versus inelastic multicomponent compression bandages in the initial treatment of leg lymphedema. Journal of Vascular Surgery: Venous and Lymphatic Disorders. 2013;1 (1):13–19. doi: 10.1016/j.jvsv.2012.05.001.

11. Zhukov B. N ., Melnikov M. A . Safety and effectiveness of elastic compression therapy in treatment of the chronic venous disease of the legs. Journal «Angiology and vascular surgery» 2011;17 (3):153–157. (In Russ.) Available at: https://elibrary.ru/item.asp?id = 17012742.

12. Kudykin M. N . Mechanical ways of thromboprophylaxis and therapy of chronic venous insufficiency: accent – compression therapy. Medicinskij sovet = Medical Council. 2017;(12):176–181. (In Russ.) doi: 10.21518/2079-701X-2017–12–176–181.

13. Grenier E., Gehin C., McAdams E., Lun B., Gobin J. P ., Uhl J. F. Effect of compression stockings on cutaneous microcirculation: Evaluation based on measurements of the skin thermal conductivity. Phlebology. 2016;31 (2):101–5. doi: 10.1177/0268355514564175.

14. Bogachev V. Y ., Boldin B. V ., Kaperiz K. A ., Turkin P. Y . Compression therapy. New technologies and opportunities. Stacionarozameshhajushhie tehnologii: Ambulatornaja hirurgija = Ambulatory surgery: hospital-replacing technologies. 2018;(1-2):32–41. (In Russ.) doi.org/10.21518/1995–14772018–1–2–32–41.

15. Mosti G., Cavezzi A., Partsch H., Urso S., Campana F. Adjustable Velcro compression devices are more effective than inelastic bandages in reducing venous edema in the initial treatment phase: a randomised controlled trial. European Journal of Vascular and Endovascular Surgery. 2015;50 (3):368–374. doi: 10.1016/j.ejvs.2015.05.014.