Short-term compression therapy in chronic vein disease without trophic disorders: possibilities of medical compression knitwear

Introduction. Medical compression stockings are one of the main methods in a conservative strategy for the treatment of chronic vein diseases as well as for adjuvant treatment after superficial venous interventions. however, compliance to this treatment is low.
Objective. To evaluate patient satisfaction with medical compression knitwear therapy in a short-term follow-up.
Materials and мethods. The study included 150 patients of both sexes aged 42 ± 8.3 years. Endovenous laser obliteration combined with mini-phlebectomy and/or sclerotherapy for varicose veins was performed. All patients after the surgery wore compression stockings of compression class 2 with a recommended wearing period of 14 days. At the control visit at the end of the follow-up period all patients were asked to complete a satisfaction survey with a specially prepared questionnaire including 7 questions.
Results and discussion. No significant adverse events and complications related to either the invasive intervention or the compression therapy were observed during the follow-up period. There were no abnormalities such as compression sensations or changes in blood flow under the knitwear. The compression was totally adequate, with no areas of over- and/or under-compression. All respondents felt that the knitwear was well anchored to the leg and no slipping or twisting due to the wide elastic band with droplet silicone. In addition to all of the above, the patients noted that the knitwear offered to them in the study had good tactile properties: it was soft and pleasant to the skin. According to the survey, the average score for all questions was 9.5 (QR 8-10).
Conclusion. Elastic compression is an effective and safe means of preventing adverse events, complications and pain in patients after superficial varicose veins surgery. Additional consumer properties of medical compression knitwear can significantly influence patients’ compliance and therefore the effectiveness of treatment.

1. Lim C.S., Davies A.H. Graduated Compression Stockings. CMAJ. 2014;186(10):E391-E398. doi: 10.1503/cmaj.131281.

2. Berszakiewicz A., Sieroń A., Krasiński Z., Cholewka A., Stanek A. Compression Therapy in Venous Diseases: Current Forms of Compression Materials and Techniques. Postepy Dermatol Alergol. 2020;37(6):836–841. doi: 10.5114/ada.2019.86991.

3. Sapelkin S.V., Letunovsky E.A., Mandzhikyan O.P., Aleksanyan V.M. Compression Therapy in the Early Postoperative Period: Struva 23/35 or Elastic Bandages? Flebologiya = Phlebology. 2007;18(1):15–18. (In Russ.).

4. Stoyko Yu.M., Kirienko A.I., Zatevakhin I.I., Pokrovsky A.V., Karpenko A.A., Zolotukhin I.A. et al. Russian Clinical Guidelines for the Diagnosis and Treatment of Chronic Venous Diseases. Phlebology. 2018;12(3):146–240. (In Russ.) doi: 10.17116/flebo20187031146.

5. Nicolaides A., Kakkos S., Baekgaard N, Comerota A., de Maeseneer M., Eklof B. et al. Management of Chronic Venous Disorders of the Lower Limbs. Guidelines According to Scientific Evidence. Part I. Int Angiol. 2018;37(3):181–254. doi: 10.23736/S0392-9590.18.03999-8.

6. Lurie F., Lal B.K., Antignani P.L., Blebea J., Bush R., Caprini J. et al. Compression Therapy after Invasive Treatment of Superficial Veins of the Lower Extremities: Clinical Practice Guidelines of the American Venous Forum, Society for Vascular Surgery, American College of Phlebology, Society for Vascular Medicine, and International union of Phlebology. J Vasc Surg Venous Lymphat Disord. 2019;718(1):17–28. doi: 10.1016/j.jvsv.2018.10.002.

7. Gianesini S., Obi A., Onida S., Baccellieri D., Bissacco D., Borsuk D. et al. Global Guidelines Trends and Controversies in Lower Limb Venous and Lymphatic Disease: Narrative Literature Revision and Experts’ Opinions Following the vwINter International Meeting in Phlebology, Lymphology & Aesthetics, 23-25 January 2019. Phlebology. 2019;34(1 Suppl.):4–66. doi: 10.1177/0268355519870690.

8. Raju S., Hollis K., Neglen P. use of Compression Stockings in Chronic Venous Disease: Patient Compliance and Efficacy. Ann Vasc Surg. 2007;21(6):790–795. doi: 10.1016/j.avsg.2007.07.014.

9. Shingler S., Robertson L., Boghossian S., Stewart M. Compression Stockings for the Initial Treatment of Varicose Veins in Patients without Venous ulceration. Cochrane Database Syst Rev. 2011;(11):CD008819. doi: 10.1002/14651858.CD008819.pub2.

10. Ayala Á., Guerra J.D., Ulloa J.H., Kabnick L. Compliance with Compression Therapy in Primary Chronic Venous Disease: Results from a Tropical Country. Phlebology. 2019;34(4): 272–277. doi: 10.1177/0268355518798153.

11. Reich-Schupke S., Murmann F., Altmeyer P., Stücker M. Quality of Life and Patients’ View of Compression Therapy. Int Angiol. 2009;28(5):385–393. Available at: https://minervamedica.it/en/journals/internationalangiology/article.php?cod=R34Y2009N05A0385.

12. Kankam H.K. N., Lim C.S., Fiorentino F., Davies A.H., Gohel M.S. A Summation Analysis of Compliance and Complications of Compression hosiery for Patients with Chronic Venous Disease or Post-thrombotic Syndrome. Eur J Vasc Endovasc Surg. 2018;55(3):406–416. doi: 10.1016/j.ejvs.2017.11.025.

13. Ziaja D., Kocełak P., Chudek J., Ziaja K. Compliance with Compression Stockings in Patients with Chronic Venous Disorders. Phlebology. 2011;26(8):353–360. doi: 10.1258/phleb.2010.010086.

14. Lugli M., Cogo A., Guerzoni S., Petti A., Maleti O. Effects of Eccentric Compression by a Crossed-Tape Technique after Endovenous Laser Ablation of the Great Saphenous Vein: A Randomized Study. Phlebology. 2009;24(4):151–156. doi: 10.1258/phleb.2008.008045.

15. Bakker N.A., Schieven L.W., Bruins R.M., van den Berg M., Hissink R.J. Compression Stockings after Endovenous Laser Ablation of the Great Saphenous Vein: A Prospective Randomized Controlled Trial. Eur J Vasc Endovasc Surg. 2013;46(5):588–592. doi: 10.1016/j.ejvs.2013.08.001.

16. Chou J.H., Chen S.Y., Chen Y.T., Hsieh C.H., Huang T.W., Tam K.W. Optimal Duration of Compression Stocking Therapy Following Endovenous Thermal Ablation for Great Saphenous Vein Insufficiency: A Meta-Analysis. Int J Surg. 2019;65:113–119. doi: 10.1016/j.ijsu.2019.03.024.

17. Weiss R.A., Sadick N.S., Goldman M.P., Weiss M.A. PostSclerotherapy Compression: Controlled Comparative Study of Duration of Compression and Its Effects on Clinical Outcome. Dermatol Surg. 1999;25(2):105–108. doi: 10.1046/j.1524-4725.1999.08180.x.

18. Kern P., Ramelet A.A., Wütschert R., Hayoz D. Compression after Sclerotherapy for Telangiectasias and Reticular Leg Veins: A Randomized Controlled Study. J Vasc Surg. 2007;45(6):1212–1216. doi: 10.1016/j.jvs.2007.02.039.

19. Nootheti P.K., Cadag K.M., Magpantay A., Goldman M.P. Efficacy of Graduated Compression Stockings for an Additional 3 weeks after Sclerotherapy Treatment of Reticular and Telangiectatic Leg Veins. Dermatol Surg. 2009;3518(1):53–58. doi: 10.1111/j.1524-4725.2008.34382.x.

20. Rabe E., Breu F.X., Flessenkämper I., Gerlach H., Guggenbichler S., Kahle B. et al. Sclerotherapy in the Treatment of Varicose Veins: S2k Guideline of the Deutsche Gesellschaft für Phlebologie (DGP) in Cooperation with the Following Societies: DDG, DGA, DGG, BVP. hautarzt. 2020. (In print) doi: 10.1007/s00105-020-04705-0.

21. Shevchenko Yu.L., Stoyko Yu.M., Mazaishvili K.V. Laser Surgery of Varicose Veins. Moscow: Borges; 2010. 198 p. (In Russ.).