Classification of compression stockings: report of the meeting of the International Compression Club, Copenhagen.

The classification of medical elastic compression stockings (MECS) according to pressure classes varies from country to country and neither provides any information on the elastic property nor on the ambulatory interface pressure profiles of the different products. Beside elasticity, MECS are also characterized by other properties such as stiffness and hysteresis. Recent research showed that MECS behaved differently in static and ambulatory conditions. Since compression therapy is most effective during ambulation, MECS should be labelled in such a way that the user can interpret its effect during walking. The importance of a more rational classification of MECS was discussed at a conference organized by the International Compression Club (ICC) attended by medical experts and representatives from MECS manufacturers. Proposals were made for labelling the MECS according to the pressure and the stiffness in an internationally acceptable format printed on the box informing both the prescribers and the patients on its properties.

Thigh-length versus below-knee compression elastic stockings for prevention of the postthrombotic syndrome in patients with proximal-venous thrombosis: a randomized trial.

Although below-knee compression elastic stockings (CES) are effective for the prevention of the postthrombotic syndrome (PTS), a substantial number of patients with deep venous thrombosis still develop PTS. In the present open-label, randomized clinical trial, we compared thigh-length with below-knee CES for the prevention of PTS. A total of 267 patients with the first episode of proximal deep venous thrombosis were randomized to wear either thigh-length or below-knee CES for 2 years. After 3, 6, 12, 18, 24, and 36 months, they were assessed for PTS manifestations according to the Villalta scale. PTS developed in 44 (32.6%) of the 135 patients randomized to thigh-length CES and in 47 (35.6%) of the 132 allocated to below-knee CES, for an adjusted hazard ratio of 0.93 (95% confidence interval, 0.62-1.41). Severe PTS developed in 3 patients in each group. CES-related side effects developed in 55 (40.7%) of the 135 patients allocated to thigh-length CES and in 36 (27.3%) of those randomized to the below-knee group (P = .017), and led to premature discontinuation of their use in 29 (21.5%) and 18 (13.6%) patients, respectively. We conclude that thigh-length CES do not offer a better protection against PTS than below-knee CES and are less well tolerated.

La insuficiencia venosa crónica / No disponible

La insuficiencia venosa es la conjunción de la dilatación y elongación de las venas de las extremidades inferiores. El sistema venoso sufre la incapacidad de cumplir con su función de drenaje. Tras diversos métodos de diagnóstico (examen clínico, diagnóstico diferencial, valoración hemodinámica etc.) se establece una clasificación según el tipo de insuficiencia venosa (primaria o venosa superficial o varices y secundaria o no postrombótica), y una clasificación según su clínica “los criterios del CEAP”. Los tratamientos existentes son diversos como: medidas higiénico-dietéticas, medias de compresión externa, venofármacos, escleroterapia y cirugía. Consiste en realizar un algoritmo de actuación en el síndrome varicoso de las extremidades inferiores, en definitiva de la patología vascular para prevenir o actuar frente a las úlceras venosas(AU)

Venous insufficiency is characterized by a dilatation and elongation of the veins of the lower extremities. The venous insufficiency is unable to work properly as a drainage system. A classification according to the type of venous insufficiency (primary, superficial venous or varicose veins and secondary or thrombotic) and a classification based on its clinical ‘The CEAP Criteria’ is established after several diagnostic methods (clinical examination, differential diagnosis, hemodynamic assessment, etc…) Different treatments exist, from hygienic and diet measures, compression stockings, sclerotherapy to surgical. Our purpose is to present an algorithm for the vascular pathology in order to prevent or perform when venous ulcers appear(AU)

[Qualitative analysis of prescription of elastic garment in lower limb venous and lymphatic diseases]. / Analyse qualitative des prescriptions de compressions élastiques pour pathologies veineuses et lymphatiques des membres inférieurs.

INTRODUCTION: Elastic garments are usually used in various venous and lymphatic diseases of the lower limbs. Precise indications are required to facilitate prescription and delivery. The aim of our article was to analyse the precision of the prescription. MATERIAL AND METHOD: We analysed all the consecutive prescriptions in March 2007 at the time of purchase of elastic stocking. Following data were anonymously recorded: patient characteristics, indication of prescription, physician (generalist or vascular). Precision of prescription was defined if type and strength of elastic garment were clearly mentioned. RESULTS: One hundred and thirty-eight prescriptions from 106 different physicians (38 vascular, 61 generalists) were analysed. Mean age of patients was 61+/-16 years (28-97), concerning 108 women (78%). It was a first prescription in 44 cases (32%). Indications of prescription were varicose veins and leg heaviness. Class II was the main mentioned strength in all indications except for plane or car travels (class I). Strength of elastic garment was defined from I to IV, but in eight cases we noted the use of the word "light", "low" or "mean". To analyse the precision of prescriptions, we selected only the first one of the same physician. Prescription was not written on a separate sheet as recommended in five of the 38 vascular physicians and nine of the 68 others (NS). Class or type of elastic garment was missing in two prescriptions of vascular physicians versus 15 of the others (P<0.05). The most mentioned type was the below knee compression garment and then full leg garment. CONCLUSION: Prescriptions of elastic garment are sometimes imprecise with a risk of error at the time of purchasing. Physicians have to learn to ameliorate the precisions of prescriptions.