From the Guidelines
The recommended strength of compression stocking for chronic venous insufficiency is 20-30 mmHg or 30-40 mmHg, depending on the severity of the disease, as stated in the most recent and highest quality study 1. The treatment of chronic venous insufficiency (CVI) involves both conservative measures and medical interventions.
- Compression therapy is the cornerstone of treatment, with graduated compression stockings providing the recommended pressure.
- Patients should wear these stockings daily, putting them on in the morning before getting out of bed.
- Regular exercise, especially walking and calf muscle exercises, helps improve calf muscle pump function.
- Weight loss is recommended for overweight patients.
- Leg elevation above heart level for 30 minutes several times daily reduces edema.
- For symptomatic relief, venoactive drugs like micronized purified flavonoid fraction (Daflon, 500 mg twice daily) or horse chestnut seed extract (300 mg twice daily) can be used.
- Pentoxifylline (400 mg three times daily) may help with skin changes.
- For venous ulcers, wound care with appropriate dressings and debridement is essential, along with compression therapy.
- In more severe cases, interventional procedures like endovenous ablation, sclerotherapy, or surgical options may be considered, as supported by studies 1. These treatments work by improving venous return, reducing venous hypertension, and alleviating symptoms by enhancing blood flow from the legs back to the heart.
- The use of compression therapy has been widely described as a helpful initial treatment for varicose veins and venous leg ulcers, with a minimum pressure of 20 to 30 mm Hg recommended, and pressures of 30 to 40 mm Hg advised for more severe disease 1.
- Adherence to compression therapy should be encouraged with proper fitting, education, and detailed instructions, despite the minimal evidence regarding its impact on quality of life 1.
From the Research
Treatment for Chronic Venous Insufficiency
The recommended treatment for chronic venous insufficiency (CVI) includes the use of compression therapy, with graduated compression stockings being the main method employed [(2,3,4,5)].
Compression Stocking Strength
- The strength of compression stockings for CVI can vary, but there is no specific information provided in the studies regarding the exact strength of knee-high compression stockings [(2,3,4,5)].
- However, it is known that compression stockings are an effective treatment for CVI, with studies showing significant improvement in symptoms such as lower extremity swelling, pain, and skin discoloration 3.
Adherence to Treatment
- Adherence to wearing compression stockings is a significant issue, with studies showing that up to 63% of patients do not use the stockings as prescribed [(2,5)].
- The reasons for non-adherence include financial constraints, pain, ignorance of the need to wear them, heat, and other factors [(2,5)].
Effectiveness of Compression Stockings
- Compression stockings have been shown to be effective in reducing symptoms of CVI, including pain, swelling, and skin discoloration [(3,4)].
- The use of compression stockings is recommended for the prevention and treatment of venous leg ulcers, as well as for the maintenance phase of lymphoedema management 4.