From the Guidelines
Compression stockings should be worn for a minimum of 1 year after diagnosis of proximal DVT to prevent postthrombotic syndrome, and for 2 years in patients with acute symptomatic DVT of the leg, with the option to continue beyond that if patients have developed postthrombotic syndrome and find the stockings helpful. This recommendation is based on the evidence from the American College of Physicians and the American Academy of Family Physicians 1, which demonstrates a marked reduction in the incidence and severity of postthrombotic syndrome among patients wearing compression stockings. However, the most recent and highest quality study suggests that compression stockings should be worn for 2 years in patients with acute symptomatic DVT of the leg 1.
Some key points to consider when wearing compression stockings include:
- Wearing them throughout the day while awake (typically 12-16 hours) and removing them at night when lying down
- Putting them on first thing in the morning before fluid accumulates in the legs to maximize their effectiveness
- Wearing them for the duration of a journey plus a few hours afterward when traveling long distances
- Consulting a healthcare provider for personalized recommendations based on the specific condition being treated
It's also important to note that compression stockings work by applying graduated pressure that's strongest at the ankle and decreases up the leg, which helps improve blood flow back to the heart, reduces swelling, and prevents blood clots. Patients should prioritize their individual needs and values when deciding whether to wear compression stockings, considering factors such as the potential benefits of preventing postthrombotic syndrome and the potential drawbacks of inconvenience and discomfort.
From the Research
Compression Stocking Duration
The recommended duration for wearing compression stockings varies depending on the individual's condition and the purpose of use.
- For patients with acute deep venous thrombosis (DVT), compression therapy is recommended as standard treatment, and the duration of treatment can be tailored individually, with some studies suggesting a duration of up to 24 months 2.
- A study found that individual, symptom-oriented tailoring of the duration of treatment was not inferior to a fixed treatment duration of 24 months 2.
- For the prevention of post-thrombotic syndrome (PTS), compression stockings have been shown to be effective, with some studies suggesting a duration of use of at least 2 years 3.
- In elderly patients with chronic venous insufficiency and swollen legs, the preventive use of compression stockings has been shown to reduce the risk of leg ulcer recurrence, with a recommended duration of use of at least 6-12 months 4.
- In neurosurgical patients, graduated compression stockings have been shown to be effective in preventing DVT when used for 14 days or until hospital discharge, if earlier 5.
Key Findings
- Compression stockings can be effective in preventing DVT and reducing the risk of leg ulcer recurrence in various patient populations.
- The duration of use can vary depending on the individual's condition and the purpose of use.
- Individual, symptom-oriented tailoring of the duration of treatment may be effective in some cases.
Study Results
- A systematic review and meta-analysis found that compression stockings can reduce the risk of PTS by 16-27% 2.
- A randomized controlled trial found that compression stockings can reduce the risk of leg ulcer recurrence by 50% or more after 2 or more years 3.
- A study found that compression stockings class 2 probably reduce the risk of leg ulcer recurrence compared to compression stockings class 1 4.