Compression Stockings

Section 1.1

Midwives may independently prescribe, order and administer this drug.

Compression stockings are designed to improve circulation, and relieve symptoms of edema and varicose veins of the lower extremities when circulation is impaired. Two types of compression stockings are available: 1) uniform compression stockings, which offer the same amount of compression to all parts of the leg and 2) graduated compression stockings, which are designed to provide support and are tightest at the ankle as pressure gradually decreases up the leg. The graduated compression helps move blood through veins towards the heart. Measurements of compression are in millimetres of mercury ranging from light support in 815 mmHg up to 30-40 mmHg and higher. Compression stockings are available in socks, stockings, knee-highs, thigh-highs or full length.

Indications and Clinical Use:

Compression stockings are used to reduce edema, prevent varicose veins, promote venous return and provide comfort.

Contraindications:

Contraindicated in those with peripheral artery disease, cellulitis and acute deep vein thrombosis.

Warnings and Precautions:

Compression pushes blood away from the leg and should be used with caution in smokers and those with a decreased blood supply to the legs, poorly controlled diabetes, neuropathy and skin infections.

Clients should be advised to report increased pain, swelling, redness or numbness when wearing compression stockings.

Prescribing:

Prescriptions require grade of compression, length and type of stocking.  All compression levels greater than 20 mmHg require a prescription. See chart below.

Clients should be advised that compression stockings are sized by height and/or by leg measurements. Correct sizing will maximize benefits and comfort. Various styles and brands may have different sizing instructions. Clients should be informed to consider the following steps when they are being fitted and measured:

  • Measure when swelling is at a minimum, usually first thing in the morning
  • Measure ankle circumference at the narrowest part of the ankle, usually right above the anklebone
  • Measure calf circumference at the fullest part of calf
  • Measure calf length from where heel touches the floor to midline at the back of knee
  • For full length stockings, measure thigh circumference at fullest part
  • Measure length of thigh from where heel touches the floor to the gluteal fold
  • For full-length stockings, measure hips at their widest part

 

Compression StrengthUse
8-15 mmHg:

      Minimal Graduated Compression

·        Lightest compression

·        Provides relief from tired or aching legs

15-20 mmHg:

      Mild Graduated Compression

·        Helpful for travel and for long periods of sitting or standing

·        May offer relief from minor varicose veins

·        Often recommended during pregnancy

20-30 mmHg:

      Moderate Graduated Compression

·        Most commonly used compression level

·        Provides relief from moderate to severe varicose veins

·        Relieves swelling and edema

·        Useful in preventing thrombosis

30-40 mmHg:

      Firm Graduated Compression

·        Provides relief from edema and severe varicose veins