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WOUND CARE TODAY
2015,Vol 2, No 1
FOCUS ON COMPRESSION HOSIERY
i
T
he use of compression
hosiery is widespread
within the community and
is an essential component of the
prevention of lower limb problems,
as well as management following a
comprehensive assessment
to determine the aetiology of
any ulceration.
Compression hosiery is a valid
alternative to multilayer compression
bandaging (Ashby et al, 2014) and
wound care clinicians should be
familiar with the types of hosiery
available and become skilled in
making the correct choice for their
patients.The focus of the article will
be on the practical considerations of
using compression hosiery, including
selection, application, removal and how
to help patients use the garments.
OBJECTIVES OF COMPRESSION
THERAPY
Compression therapy is the application
of graduated pressure to the lower
leg, with higher pressure at the
ankle reducing to below the knee.
Compression hosiery to manage
venous leg ulcers and oedema
treatment is prescribed (Clinical
Resource Efficiency Support Team
[CREST], 1998; RCN, 2006; Scottish
Intercollegiate Guidelines Network
[SIGN], 2010).Venous insufficiency
affects up to 50% of the adult
population (Venous Forum, 2011) and
an estimated 1% of the population will
have a leg ulcer in their lifetime, with
venous disease accounting for 60–80%
of leg ulceration (Callam, 1992).
Additionally, chronic oedema poses
a challenge for the nurse, although it
can be managed with hosiery. Chronic
oedema is an accumulation of fluid,
proteins and other macro-molecules
leading to tissue swelling, skin changes
and fibrosclerosis. It is a symptom of
many different clinical conditions and
affects over 100,000 people in the UK
(Moffatt et al, 2007). Chronic oedema
has become an increasing issue for
nurses and appropriate management
can be highly effective in improving the
patient’s quality of life.
Compression hosiery can be used
to achieve several things:
i
Prevention of venous leg
ulcer recurrence
i
Healing of venous ulcers
i
Primary prevention of leg
ulcers where varicose veins are
present or patients have known
risk factors
Jackie Stephen-Haynes, professor in tissue
viability, Professional Development Unit,
Birmingham City University and consultant
nurse, Worcestershire Health and Care NHS Trust;
Rosie Callaghan, tissue viability nurse specialist,
Worcestershire Health and Care NHS Trust
IN BRIEF
Compression therapy is the application of graduated pressure
to the lower leg, with the higher pressure at the ankle reducing to
below the knee.
Compression is provided in a number of ways, most commonly
using bandaging and hosiery.
A sound knowledge of the options will support the clinician when
selecting and supplying the most appropriate hosiery.
KEY WORDS:
Compression
Hosiery
Lower limb
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Jackie Stephen-Haynes, Rosie Callaghan
Compression supports the superficial
veins and counteracts raised capillary
pressure and is provided in a number of
ways, most commonly using bandaging
and hosiery (Moffatt et al, 2007).
Compression hosiery is suitable
for patients with chronic venous
insufficiency, post-thrombotic
syndrome, varicose veins, venous
eczema, lipodermatosclerosis and
swelling in the legs associated with
pregnancy (National Institute of
Health and Care Excellence [NICE],
2012). Compression hosiery offers
cost-effective therapy that promotes
healing in venous ulceration (Ashby
et al, 2014). It can prevent recurrence
and can contain chronic oedema; thus
significantly improving a patient’s
clinical outcomes (Osborne, 2009).
Annual costs for leg ulcer care
and management are conservatively
estimated to be in the region of £200
million and, with age featuring as a key
predisposing factor, the demographic
profile of the UK will result in a
continually increasing financial burden
(Moffatt et al, 2004; Persoon et al, 2004;
Posnett and Franks, 2008).
The key factor when treating
people with leg ulcers is to establish
the underlying aetiology to
ensure that the most appropriate
