8 Sevitt reported that venous thrombi can form on intact endothelium. 2 Their role in the prevention of vascular stasis has been a recent focus of interest because improved venographic studies after total hip replacement showed that the site of the origin of the thrombi was in almost all cases related to the venous valve cusps. It has been suggested that graduated compression stockings prevent passive dilation of the veins progressing to the point where subendothelial tears occur, activating clotting factors and leading to venous thrombosis. Knee length graduated compression stockings are similarly efficient in decreasing venous stasis, but they are more comfortable to wear, and they wrinkle less.Īlthough graduated compression stockings are the most commonly used method of mechanical prophylaxis against deep venous thrombosis after orthopaedic surgery, 5,7,10 the mechanisms by which the stockings prevent deep venous thrombosis are not completely understood. Thigh and knee length stockings have a significant effect on decreasing venous stasis of the lower limb. All stockings were reported to be difficult to use.
The knee length graduated compression stockings wrinkled significantly less, and significantly fewer patients reported discomfort with them. Visual assessment of the fit and use of stockings was done, and patients’ subjective opinion of comfort was sought. There was no significant change in the venous capacitance and venous outflow in patients in the control group. The knee length Brevet stockings were less efficient in increasing the venous outflow. There was no difference in the mean of the percentage change of venous capacitance in patients in the four groups wearing stockings. After 20-minutes bed rest there was a highly significant increase in venous capacitance and venous outflow in patients in all of the four groups wearing stockings. Venous occlusion strain gauge plethysmography was used to measure venous flow. Patients in the fifth control group did not wear graduated compression stockings. Patients having elective orthopaedic surgery at a university orthopaedic department were randomized into five groups to wear two different types of graduated compression stockings in thigh and knee lengths. In the current study the physiologic effect of low-pressure graduated compression stockings on the venous blood flow in the lower limb and the practical aspects of their use were assessed. The mechanisms by which graduated compression stockings prevent deep venous thrombosis are not completely understood.
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