54
WOUND CARE TODAY
2015,Vol 2, No 1
FOCUS ON COMPRESSION HOSIERY
›
as many as they liked in order of
preference, with the following results:
›
92% (n=36) selected hosiery based
upon patient concordance
›
86% (n=36) selected hosiery based
upon level of compression
›
83% (n=35) selected hosiery due
to sizing and fit
›
64% (n=27) were influenced
by the local wound
management formulary.
When prescribing hosiery, it is
important to advise the patients that
they may have to wear hosiery as
long as their venous disease persists.
Nurses should consult with the
patient when choosing the type of
hosiery used, especially regarding
colour and style, and whether the
hosiery is open- or closed-toe, below-
knee or thigh-length.
Concordance can be an issue.
Rather than using ready-made
hosiery, a made-to-measure garment
may help with this and nurses
should aim for the optimum level
of compression while recognising
that any compression is better than
none, particularly if the patient has
difficulty coping with garments that
exert a higher pressure.
British Standard hosiery will
need replacing every three months
whereas European Standard will
need to replaced every six months.
Hosiery that is suitable for oedema
should be prescribed when swelling is
present. A stiffer garment would be the
most appropriate to use in this case.
CONCLUSION
A sound knowledge of the options
will help the nurse when selecting
the most appropriate hosiery. Hosiery
can be convenient for patients and
is often tolerated where multilayer
bandaging may not be. It can provide
consistent pressures and makes
efficient use of resources as it can
be washed several times while still
providing effective compression.
The selection of appropriate
hosiery in collaboration with the
patient can result in considerable
cost savings and, more importantly,
improve the patient’s quality of life
(Ashby et al, 2014).
WCT
REFERENCES
Ashby RL, Gabe R, Ali S, et al (2014)
Lancet
383(9920):
871–9
Burgess B, Robinson B (1993)
Nurs Times
89(13):
90–2
The study looked at patient
concordance, quality of life, healing
and cost. Researchers showed that the
median time to healing in the hosiery
kits and the four-layer bandages was
roughly similar, however the recurrence
rate was only 4% in the hosiery kit
group, compared to 23% in the four-
layer bandage group.The annual cost of
hosiery was £1,493.90, a saving of £300
on the cost of four-layer bandaging.
PRESCRIBING
The importance of competence
for all practitioners involved in the
assessment, selection and fitting of
hosiery and the impact on clinical
and financial outcomes is significant.
In a 40-patient study, Stephen-
Haynes and Sykes (2013) sought to
identify factors that influence hosiery
selection by asking nurses to fill in
a checklist. Nurses were given a list
of options and were asked to tick
›
Top tips...
›
Hosiery should have a soft and silky feel but can be damaged by direct
heat and washing at high temperatures.
›
Hosiery should be washed following the manufacturer’s instructions,
usually by hand at 40 degrees, and dried flat away from direct heat.
›
Hosiery must not be tumble-dried, ironed, bleached or dry-cleaned.
›
Hosiery can be damaged by fingernails and toenails, and jewellery, so
care must be taken when putting garments on.
Table 2:
European Standard Drug Tariff classification for compression hosiery
Class
Pressure
Support
Indications for use
Class1
18–21mmHg
Light
›
Early varicose veins
›
Mild-ankle oedema
Class 2
25–32mmHg
Medium
›
Medium severity varicose veins
›
Post-thrombotic limb
›
Mild oedema
›
To prevent recurrence of venous ulcers
Class 3
36–46mmHg
Strong
›
Severe varicose veins
›
Gross oedema
›
Chronic insufficiency
›
To prevent recurrence of venous ulcers
Class 4
More than
59mmHg
Very strong
›
Gross oedema
›
Lymphoedema
›
Elephantiasis
›
Further information
To find out more about the issues
covered in this article and to access
relevant clinical information, try the
industry websites below:
›
AltiMed:
/
products/altiform
›
Medi UK:
›
Activa Healthcare:
/
compression-hosiery
