III. Contraindications

IV. Technique

  1. Pressure should increase distally from knee to ankle (Graduated)
  2. Wear stockings throughout day (remove at night)
  3. Apply stockings in the morning before swelling starts to increase
  4. Avoid OTC low pressure stockings for DVT Prevention
  5. Knee length stockings are more comfortable and as effective as thigh length
  6. Smooth-out stockings and avoid the stocking bunching-up on application
  7. Allow any Topical Lotions to dry before applying stockings
  8. Consider applying talc before applying stocking
  9. Stocking application Assistive Devices are available (e.g. stocking butler, stocking donner)
  10. Non-custom stockings as effective as Custom stockings
    1. However, proper measurements from a certified fitter (e.g. Medical Supply Store or Pharmacy) is recommended

V. Dosing

  1. Mild Compression (<20 mmHg): Non-Medical Grade OTC
    1. Not generally recommended due to low efficacy
    2. Includes most T.E.D. Hose and OTC Compression Socks
    3. Does not prevent DVT
    4. May reduce venous pooling in patients on their feet throughout the day, but minimally effective
  2. Medium Compression (20-40 mmHg): Medical Grade
    1. Stockings for Venous Insufficiency and Venous Ulcers
    2. May also reduce DVT Risk on prolonged airplane flights
    3. May decrease pain in post-thrombotic syndrome
  3. High Compression (>40 mmHg)
    1. Severe Venous Insufficiency
    2. Chronic Lymphedema

VI. Preparations

  1. Anti-embolism stockings (e.g. TED stockings)
    1. Pressure: 8-10 mmHg
  2. Elasticized tubular gauze (e.g. Tubigrip)
    1. Pressure: 15-20 mmHg
    2. Indications
      1. Older patients with Venous Insufficiency
  3. Single layer elastic wrap (e.g. ACE Wrap)
    1. Pressure: 20 mmHg
  4. Compression Stockings (e.g. Jobst, Juzo)
    1. Pressure: 30-40 mmHg
    2. Indications
      1. Severe Venous Insufficiency or Lymphedema
    3. Custom Jobst Stockings
      1. Based on circumference at every 1.5 inches up leg
      2. Indications
        1. Large calf with narrow ankle (risk of Tourniquet)
        2. Lipodermatosclerosis
  5. Multi-layer compression Wraps (e.g. Dynaflex)
    1. Pressure: 30-40 mmHg
    2. Indications
      1. Severe Venous Insufficiency or Lymphedema

VII. Coding

  1. HCPCS: L8100

VIII. References

  1. (2019) Presc Lett 26(10): 56

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Ontology: Compression Stockings (C0038348)

Definition (MSH) Tight coverings for the foot and leg that are worn to aid circulation in the legs, and prevent the formation of EDEMA and DEEP VEIN THROMBOSIS. PNEUMATIC COMPRESSION STOCKINGS serve a similar purpose especially for bedridden patients, and following surgery.
Concepts Medical Device (T074)
MSH D053828
SnomedCT 90477009, 348681001
English Graduated compressn elast hose, LEGGING, COMPRESSION, NON-INFLATABLE, Compression Stocking, Stocking, Compression, Stockings, Compression, Stockings, Antiembolic, Hose, Antiembolic, Support Hose, Antiembolic Stockings, Support hose, compression stocking, antiembolic stockings, support hose, antiembolic stocking, hose support, compressions stockings, compression stockings, Antiembolic stockings, Antiembolic stockings, device (physical object), Antiembolic stockings, device, Graduated compression elastic hosiery, Graduated compression elastic hosiery (physical object), Compression Stockings
Portuguese Meias de Compressão, Meias Compressivas
Spanish Medias de Compresión, Medias Compresivas, medias elásticas para prevención de embolia (objeto físico), medias antiembolia, medias elásticas para prevención de embolia, medias elásticas de compresión graduada (objeto físico), medias elásticas de compresión graduada
Russian ЭЛАСТИЧНЫЕ ЧУЛКИ, ЧУЛКИ КОМПРЕССИОННЫЕ, КОМПРЕССИОННЫЕ ЧУЛКИ, ЧУЛКИ ЭЛАСТИЧНЫЕ, KOMPRESSIONNYE CHULKI, CHULKI ELASTICHNYE, CHULKI KOMPRESSIONNYE, ELASTICHNYE CHULKI
Italian Calze elastiche a compressione graduata
German Strümpfe,Kompressions-
French Bas de contention, Chaussettes de contention, Chaussettes à compression, Bas à compression
Swedish Kompressionsstrumpor
Finnish Puristussukat
Polish Materiały obciskające, Pończochy uciskowe, Opatrunki elastyczne, Bandaże elastyczne, Opatrunki uciskowe
Japanese 圧縮靴下, 靴下-弾性, 着圧ストッキング, 弾性ストッキング, 弾力性ストッキング, 圧迫靴下, コンプレッションストッキング, 弾力ストッキング, 圧迫ストッキング, 靴下-圧迫, ストッキング-弾性, 弾性靴下
Czech punčochy kompresní, kompresivní punčochy
Norwegian Kompresjonsstrømper, Støttestrømper, Antitrombosestrømper