Graduated compression stocking

Moderate Major or minor surgery, age 40-60 years, and no clinical risk factors Major surgery, age less than 40 years, and no clinical risk factors Minor surgery, with clinical risk factor(s) Acutely ill (e.g., myocardial infarction, ischemic stroke, heart failure exacerbation), and no clinical risk factors 10-20 1-2 I o UFH 5000 units SC every 12 hours Dalteparin 2500 units SC every 24 hours Enoxaparin 40 mg SC every 24 hours Tinzaparin 3500 units SC every 24 hours IPC Graduated compression stockings... 

Postthrombotic syndrome occurs in 20% to 50% of patients within 8 years after a DVT. Wearing graduated compression stockings (GCS) after a DVT reduces the risk of PTS by as much as 50%. Current guidelines recommend the use of GCS with an ankle pressure of 30 to 40 mm Hg for 2 years after a DVT. To be effective, GCS must fit properly. Traditionally, strict bed rest has been recommended after a DVT, but this approach has now been refuted and patients should be encouraged to ambulate as tolerated.8,34... 

Encourage all patients who have had DVT to wear graduated compression stockings. 

CCS graduated compression stockings SBP systolic blood pressure... 

Deep vein thrombosis prophylaxis is recommended for septic patients. Low-dose unfractionated heparin or low-molecular-weight heparin may be utilized. Graduated compression stockings or an intermittent compression device is recommended for patients with a contraindication to heparin products (thrombocytopenia, severe coagulopathy, active bleeding, or recent intracerebral hemorrhage).24... 

Nonpharmacologic methods improve venous blood flow by mechanical means and include early ambulation, electrical stimulation of calf muscles during prolonged surgery, graduated compression stockings, intermittent pneumatic compression devices, and inferior vena cava filters. 

Only a handful of smdies have formally evaluated the cost-effectiveness of VTE prevention strategies. The acquisition costs of graduated compression stockings, heparin, and warfarin are considerably less than those of the LMWHs, DTls, and fondaparinux. However, the acquisition cost for drug therapy is relatively small when compared with the overall cost of care. Economic analyses must take into account the efficacy of the strategy, treatment complications, and monitoring costs. 

In addition to anticoagulant therapy for patients with proximal DVT, wearing graduated compression stockings can rednce the risk of developing the postthrombotic syndrome by as mnch as 50%. To be... 

Agu O, Hamilton G, Baker D. Graduated compression stockings in the prevention of venous thromboembolism. Br J Surg 1999 86 992-1004. 

Hanley TP, Kiev J, Rice JC, Kerstein MD (1997) Long-term prevention of sequelae of chronic venous disease with graduated-compression stockings. J Vase Surg 31 451-455 Horner J, Fernandez JFE, Nicolaides AN (1980) Value of graduated compression in deep venous insufficiency. BMJ 75 820-821... 

Prevention of deep vein thrombosis (graduated compression stocking), mild edema, aching legs (occupational leg symptoms)... 

Dennis M, et al. Effectiveness of thigh-length graduated compression stockings to reduce the risk of deep vein thrombosis after stroke (CLOTS trial 1) a multicentre, randomised controlled trial. Lancet 2009 373(9679) 1958—65. 

Following the procedure, patients should be placed into a Class II (30-40 mmHg) graduated compression stocking (GCS) usually for 2 weeks. The purpose of this is to keep the variceal tributaries as empty as possible in case they occlude to minimize the amount of resultant thrombus. The GCS also increases the velocity of blood flow in the deep veins decreasing the likelihood of deep vein throm-... 

Agu O, Baker D, Seifalian AM. Effect of graduated compression stockings on limb oxygenation and venous function during exercise in patients with venous insufficiency. J Vase Surg 2004 12 69-76. 

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