Compression stockings for varicose veins in patients without venous ulceration

Compression stockings may improve subjective symptoms of varicose veins in patients without healed or active venous ulceration.

Summary

A Cochrane review included 7 studies with a total of 356 subjects with varicose veins without healed or active venous ulceration. Different levels of pressure were exerted by the stockings in the studies, ranging from 10 to 50 mmHg. One study assessed compression hosiery versus no compression hosiery. However, there were no data for the group that did not wear hosiery and the outcome of this study was compliance in pregnant women, not improvement of symptoms or physiological measures. The other six studies compared different types or pressures of stockings. The symptoms subjectively improved with the wearing of stockings across trials that assessed this outcome, but these assessments were not made by comparing one randomised arm of a trial with a control arm and are therefore subject to bias. Meta-analyses were not undertaken due to inadequate reporting and actual or suspected high levels of heterogeneity. No conclusions regarding the optimum length of compression stocking can be made as there were no conclusive results from the included studies. Conclusions from individual studies regarding the optimum pressure provided by stockings are conflicting, although the results of one study suggested that lower pressured stockings (20 mmHg) may be as effective for relieving symptoms as higher pressured stockings (30 to 40 mmHg).

Clinical comments

The decision to use stockings will depend on the severity of symptom, degree of swelling, and the presence of skin discolouration as a risk indicator for venous ulcer.

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Ədəbiyyat

1. Shingler S, Robertson L, Boghossian S et al. Compression stockings for the initial treatment of varicose veins in patients without venous ulceration. Cochrane Database Syst Rev 2013;(12):CD008819. .