From the Guidelines
Chronic venous stasis treatment should prioritize compression therapy, with graduated compression stockings (20-30 mmHg or 30-40 mmHg for more severe cases) worn daily from morning to night, as the cornerstone of treatment, as recommended by the most recent and highest quality study 1.
Key Components of Treatment
- Compression therapy: + Graduated compression stockings (20-30 mmHg or 30-40 mmHg for more severe cases) + Worn daily from morning to night
- Elevation of legs: + Above heart level for 30 minutes, 3-4 times daily + To reduce swelling
- Regular exercise: + Particularly walking + Helps activate the calf muscle pump to improve venous return
- Weight loss: + Recommended for overweight patients
- Skin care: + Use mild, fragrance-free moisturizers daily + Prevent dryness and cracking, avoiding products with potential irritants
- Wound care (if ulcers develop): + Appropriate dressings (hydrocolloid, foam, or alginate) + Changed every 1-3 days depending on drainage ### Medications and Procedures
- Medications: + Pentoxifylline (400 mg three times daily with meals) to improve microcirculation + Micronized purified flavonoid fraction (1000 mg daily) to reduce edema and symptoms
- Diuretics: + Should be used cautiously and only for short periods
- Procedures (for severe cases unresponsive to conservative treatment): + Endovenous ablation + Sclerotherapy + Surgical interventions These treatments work by addressing the underlying pathophysiology of venous hypertension, which causes fluid accumulation, inflammation, and tissue damage in the lower extremities, as supported by 1, 2, 3, 4, 5, 6.
From the Research
Treatment Options for Chronic Venous Stasis
- Compression therapy is a widely used treatment for chronic venous stasis, aiming to reduce swelling, maintain limb size, and enable patient participation in care 7.
- Compression therapy can be achieved through various methods, including static compression, specialized compression pumps, and manual lymphatic drainage 7.
- Medical compression stockings are a standard, non-invasive treatment option for venous and lymphatic diseases, with evidence supporting their use in preventing and treating venous edema and ulcers 8.
Compression Stockings and Venous Disease
- Compression stockings have been shown to be effective in reducing pain and swelling in patients with acute deep vein thrombosis, and are recommended for use in the maintenance phase of lymphedema management 8.
- The use of compression stockings in preventing post-thrombotic syndrome is still recommended, despite conflicting results from recent studies 8.
- Graduated and progressive compression stockings have been found to decrease the cross-sectional area of leg veins in patients with chronic venous disease, and to lower viscosity and increase distensibility of the small saphenous vein 9.
Adherence to Treatment
- Adherence to wearing graduated compression stockings is a significant issue, with a study finding that 44.2% of patients were non-adherent, citing financial reasons, pain, and ignorance of the need to wear them as common reasons 10.
- The adherence rate to wearing compression stockings was found to be 55.8% in a study of public health system patients, highlighting the need for education and support to improve treatment outcomes 10.
Key Findings
- Compression therapy is a effective treatment for chronic venous stasis, with medical compression stockings being a key component of treatment 7, 8, 11.
- Graduated and progressive compression stockings have been found to have beneficial effects on leg vein cross-sectional area and viscoelasticity in patients with chronic venous disease 9.
- Adherence to treatment is a significant issue, with financial and educational barriers contributing to non-adherence 10.