Compression

In most cases, compression stockings are used to treat venous disorders in the legs. Chronic venous insufficiency (CVI) is a condition where the valves in the veins that normally keep blood from flowing back into the legs do not close properly. As a result, blood can pool in the legs and the walls of the veins become overloaded. Varicose veins or oedema are possible consequences. Compression stockings reduce the diameter of the affected veins by applying pressure from the outside, so that the venous valves close better again. Compression treatment may also be indicated for hypertrophic scars and keloids for a limited period of time.

Products of different lengths are available, such as knee-highs, thigh-highs or tights. Combinations of Bermuda trousers with thigh-highs or Capri trousers with knee-highs are also possible, and there are also compression items for the arms. When making a choice, you always have to weigh up between wearing comfort and the required compression effect. The general rule is: as short as possible, as long as necessary.

Medical compression (arm) stockings and tights that are listed in the register of medical Aids of the health insurance funds meet the manufacturing and testing guidelines of the Gütezeichengemeinschaft Medizinischer Kompressionsstrümpfe e. V. (Quality Mark Association for Medical Compression Stockings). (RAL-GZ 387). This can be recognised by the quality mark of the quality mark association. Corresponding stockings must have two-way properties and be assignable to one of the compression classes (KKL) defined in the quality regulations. There are four KKL for leg stockings and three for arm stockings. The doctor decides which class the patient needs. There is no rigid assignment of a KKL to a certain clinical picture. Another quality feature is that compression articles for the legs have a continuous pressure drop from the ankle to the centre of the body, the arm stocking from the wrist to the centre of the body. This corresponds to the natural pressure conditions in the body.

To ensure that the stockings fit like a second skin, the pharmacy team measures the circumference and length of the limbs. It is ideal to take the measurement early in the morning, as soon as possible after getting up, as the oedema is less pronounced then in the evening. If the individual measurements correspond to a mass-produced product, choose this; otherwise, a custom-made product is necessary. Stockings from series production are always made in a circular knitting process, i.e. they do not have a seam.

Made-to-measure products are required when the individual body measurements or body shape do not fit a standard product. A distinction is made between circular knitted and flat knitted products. Circular knitted compression stockings made to measure do not have any disturbing seams. However, the circular knitting process sets limits to the shaping, as the number of stitches cannot be changed. These compression stockings are usually finer and thinner than flat-knitted compression stockings and are typically used for vein complaints.

Made-to-measure, flat-knitted compression stockings are still sewn up after the knitting process so that a visible longitudinal seam remains. The shape is thus much better adapted to the body shape than with circular knitted compression stockings, but they are usually also thicker and rougher than circular knitted stockings. They are preferably used when a higher stiffness of the knitted fabric and more pressure on the tissue are necessary due to the disease, for example in the case of lymphoedema and lipoedema. Every patient is entitled to at least two compression stockings per year. It is also possible that two pairs are prescribed at once. This is often the case with first-time prescriptions, so that an exchange pair is available.

For compression therapy to work, patients need to wear the stockings consistently and regularly. A common concern for sufferers is that they may not be able to put the stockings on by themselves. The PTA can advise to first gather the compression stocking up to the toe in the hands and then pull it over the stretched toe and slowly pull up the leg. Aids such as sliding socks can also make it easier to put them on. They are made of a smooth material and are pulled onto the foot before the compression stocking is put on. Then, depending on the variant, they can be removed upwards via the open toe of the compression stockings or via straps attached to the sliding sock. Then there are metal devices with which patients can pre-stretch the stockings.

Rubber gloves with a knobbed structure make it easier to grip and pull up the stockings, and they also protect the knitted fabric. Such donning and doffing Aids can in principle also be prescribed at the expense of the SHI system as product group 02 of the list of Aids. Especially immobile or elderly patients can ask their doctor about this.