6, 7 Patients who are allergic to the stocking material may develop contact dermatitis, skin discoloration and blistering. The use of graduated compression stockings on legs with impaired arterial flow can worsen ischemia. Poorly fitting stockings can cause discomfort and, at worst, pressure necrosis. ![]() 6 – 9 The stockings are generally safe to use, with relatively few complications. The contraindications of graduated compression stockings are listed in Box 3. 4 Another study showed that levels of proinflammatory cytokines (e.g., interleukin-1α, interleukin-6 and interferon-γ) in ulcer tissue in patients with active ulcers were significantly reduced following compression therapy. 2, 4, 5 One study that used near-infrared spectroscopy to monitor changes in tissue oxyhemoglobin and deoxyhemoglobin reported that limb oxygenation increased with the use of graduated compression stockings, especially with high-compression stockings. 3 It also initiates complex physiologic and biochemical effects involving the venous, arterial and lymphatic systems, although the exact mechanisms remain unclear. 2 Graduation compression can reverse venous hypertension, augment skeletal-muscle pump, facilitate venous return and improve lymphatic drainage. The application of adequate graduated compression reduces the diameter of major veins, which increases the velocity and volume of blood flow. The pressure gradient ensures that blood flows upward toward the heart instead of refluxing downward to the foot or laterally into the superficial veins. The stockings work by exerting the greatest degree of compression at the ankle, with the level of compression gradually decreasing up the garment. ![]() What are the mechanisms of action of compression stockings?įigure 2 summarizes the mechanisms of action of graduated compression stockings.
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