TED hose (compression stocking)
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Introduction
Elastic stocking (hose) that provide compression the lower extremities. Above & below the knee stockings are available.
Indications
- adjunctive management of lower extremity edema
- adjunctive treatment in prevention of vasovagal reaction[11]
- adjunctive management for prevention of deep-vein thrombosis (DVT)
- often used in connection with synchronized compression devices (SCD)
- thigh length compression stockings more effective inpreventing DVT than below the knee compression stockings[2][3]
- neither thigh length nor below the knee length stockings very helpful in preventing symptomatic proximal DVT or pulmonary embolism[3]
- may reduce recurrence of venous leg ulcers[5]
Contraindications
- wounds that would preclude their use
- compression stockings do not reduce the risk for deep venous thrombosis after stroke[2][8]
- compression stockings do not reduce the risk for post-thrombotic syndrome after DVT[4]
- post-surgical prophylaxis for venous thromboembolism[10]
Benefit/risk
- do not use compression stockings for prophylaxis[6][10]
- skin damgage cited as harm[6]
- graduated compression stockings for post surgical patients
- number needed to treat to prevent 1 DVT = 7-9[7]
- unknown number harmed from discomfort[7]
- effective in diminishing risk of DVT in hospitalised patients[8]
- more effective when used with another method of DVT prophylaxis[8]
- effectiveness of graduated compression stockings for hospitalized medical patients is uncertain[7]
- no benefit after stroke[2][9]
Complications
Notes
- 20-30 mm Hg compression is standard.
- ankle pressure 30-40 mm Hg for DVT
TEDs (terrible elastic devices)
- Order under prosthetics
- Select stockings in prosthetics menu
- VA carries below knee stocking only
More general terms
References
- ↑ Veteran's Administration, Delacruz, P
- ↑ 2.0 2.1 2.2 2.3 The CLOTS Trials Collaboration Effectiveness of thigh-length graduated compression stockings to reduce the risk of deep vein thrombosis after stroke (CLOTS trial 1): a multicentre, randomised controlled trial The Lancet, Early Online Publication, 27 May 2009 doi:10.1016/S0140-6736(09)60941-7 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60941-7/abstract
- ↑ 3.0 3.1 3.2 3.3 The CLOTS (Clots in Legs Or sTockings after Stroke) Trial Collaboration* Thigh-Length Versus Below-Knee Stockings for Deep Venous Thrombosis Prophylaxis After Stroke. A Randomized Trial. Ann Intern Med. 2010 Nov 2;153(9):553-62. Epub 2010 Sep 20. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20855784 <Internet> http://www.annals.org/content/early/2010/09/20/0003-4819-153-9-201011020-00280.full
- ↑ 4.0 4.1 Kahn SR et al. Compression stockings to prevent post-thrombotic syndrome: A randomised placebo-controlled trial. Lancet 2013 Dec 6 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24315521 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61902-9/fulltext
- ↑ 5.0 5.1 Ashby RL et al. Clinical and cost-effectiveness of compression hosiery versus compression bandages in treatment of venous leg ulcers (Venous leg Ulcer Study IV, VenUS IV): A randomised controlled trial. Lancet 2013 Dec 6 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24315520 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62368-5/fulltext
- ↑ 6.0 6.1 6.2 Lederle FA et al Venous Thromboembolism Prophylaxis in Hospitalized Medical Patients and Those With Stroke: A Background Review for an American College of Physicians Clinical Practice Guideline Annals of Internal Medicine November 1, 2011 155(9):602-615 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22041949 <Internet> http://www.annals.org/content/155/9/602.abstract corresponding NGC guideline withdrawn Nov 2016
Qaseem A et al Venous Thromboembolism Prophylaxis in Hospitalized Patients: A Clinical Practice Guideline From the American College of Physicians Annals of Internal Medicine November 1, 2011 155(9):625-682 http://www.annals.org/content/155/9/625.full.pdf+html corresponding NGC guideline withdrawn Nov 2016 - ↑ 7.0 7.1 7.2 7.3 The NNT: Elastic Stockings for Deep Vein Thrombosis Prevention After Surgery. http://www.thennt.com/nnt/elastic-stockings-for-deep-vein-thrombosis-prevention-after-surgery/
The NNT: Elastic Stockings Plus Medical Therapy for Deep Vein Thrombosis Prevention After Surgery. http://www.thennt.com/nnt/elastic-stockings-plus-medical-therapy-for-deep-vein-thrombosis-prevention-after-surgery/
Sachdeva A, Dalton M, Amaragiri SV, Lees T. Graduated compression stockings for prevention of deep vein thrombosis. Cochrane Database Syst Rev. 2014 Dec 17;12:CD001484. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25517473 - ↑ 8.0 8.1 8.2 8.3 The NNT: Elastic Stockings Plus Medical Therapy for Deep Vein Thrombosis Prevention After Surgery http://www.thennt.com/nnt/elastic-stockings-plus-medical-therapy-for-deep-vein-thrombosis-prevention-after-surgery/
Sachdeva A, Dalton M, Amaragiri SV, Lees T. Elastic compression stockings for prevention of deep vein thrombosis. Cochrane Database Syst Rev. 2010 Jul 7;(7):CD001484. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20614425 - ↑ 9.0 9.1 The NNT: Graduated Compression Stockings for Prevention of Deep Vein Thrombosis in Stroke Patients
Naccarato M, Chiodo Grandi F, Dennis M, Sandercock PA. Physical methods for preventing deep vein thrombosis in stroke. Cochrane Database Syst Rev. 2010 Aug 4;(8):CD001922 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20687069 - ↑ 10.0 10.1 10.2 American Academy of Nursing Twenty-Five Things Nurses and Patients Should Question Choosing Wisely. An initiative of the ABIM Foundation Released April 19, 2018 (21-25) http://www.choosingwisely.org/societies/american-academy-of-nursing/
- ↑ 11.0 11.1 Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019