Venous skin ulcers: Using compression stockings
Introduction
A
venous skin ulcer is an open wound that typically
develops on the
lower leg and can take months to heal. If you have had a venous skin ulcer
before or have one of a number of high-risk conditions that impair your
lower-leg blood circulation, you have a significant risk of developing a venous
skin ulcer.
Key points
- Wearing compression stockings is the single
most effective way of controlling the painful fluid buildup and pooling of
blood in the lower legs that cause venous skin ulcers.
- You can
greatly improve your chances of remaining ulcer-free by wearing compression
stockings on a daily basis.
- If you develop a venous skin ulcer, you
can speed healing by wearing compression stockings during your waking hours and
elevating your legs above the level of your heart whenever you can.
Specially fitted
compression stockings are designed to help prevent blood from pooling in the
legs. Compression stockings:
- Are tightest at the foot. The tightness
gradually gets less and less until you reach the top of the stocking (graduated
compression).
- Cover the leg from the arch of your foot to just
below or above your knee, or they cover the leg like panty hose.
- Can be purchased from
a medical supply store with a doctor's prescription. They may cost between $60
and $100 a pair (panty hose style are more expensive) and usually need to be
replaced after 4 to 6 months of regular use.
- Are available without
a prescription. But nonprescription support hose do not provide the higher
level of compression needed to prevent venous skin ulcers.
Test Your Knowledge
Compression stockings are tight and help improve blood
flow from the leg back to the heart.
- True
This answer is correct.Compression stockings are tightest at the foot
and become gradually less tight moving up the stocking toward the heart. This
helps the weak veins and muscles pump blood toward the heart.
- False
This answer is incorrect.Compression stockings are tightest at the foot
and become gradually less tight moving up the stocking toward the heart. This
helps the weak veins and muscles pump blood toward the heart.
-
Continue to Why?
If you
have had a venous skin ulcer before or are considered at risk for developing
one, it is very important that you use compression stockings during waking
hours to keep your blood circulating. When blood and fluid pool in your lower
legs, your lower legs become swollen and achy. Eventually your skin begins
to break down, forming open wounds. A skin ulcer can become a long-standing
problem.
Test Your Knowledge
I only need to wear compression stockings when I'm on
my feet a lot.
- True
This answer is incorrect.Unless your feet are elevated above the level
of your heart, blood is likely to pool in your lower legs if you are at risk
for developing venous skin ulcers. Compression stockings are necessary for
preventing this problem.
- False
This answer is correct.Unless your feet are elevated above the level
of your heart, blood is likely to pool in your lower legs if you are at risk
for developing venous skin ulcers. Compression stockings are necessary for
preventing this problem.
-
Continue to How?
At first,
putting on a pair of compression stockings can be tricky. But with some practice you'll find the
best technique for you. Consider the following:
- If your compression stockings are new, it might
help to wash them before putting them on. This can help make the stockings more
flexible and easier to put on. Hand-washing your stockings is a good idea.
- Make sure you put a dressing on any
open wound before putting on the compression stockings.
- Sit in a
chair with a back while you put on the stockings. This gives you something to
lean against as you pull up the stockings.
- It is usually best to
put on the stockings early in the morning, when you have the least swelling in
your legs. Put silicone lotion (such as ALPS) or talcum powder on your legs to
help the stockings slide on.
- Turn your stocking inside out, and
place your toe in as far as it will go. Readjust the stocking by folding it
back onto itself at the ankle and grab both sides of the folded stocking. Pull
toward your body as far as you can. Fold back the stocking again farther up on
your leg, and pull the stocking up to that point. Repeat folding back and
pulling until the stocking is correctly placed. See a picture of
how to put on compression stockings.
- Wearing rubber gloves may help
grip the fabric. For a toeless stocking, wear a silk "slip sock" (from your
medical supplier) to help the stocking slide over your foot more easily. Pull
the slip sock off through the open toe when you're done.
- If you're
still having trouble, use a "stocking butler," a metal device that holds the
stocking open while you step into it. Although this device is often recommended
for people who have trouble grasping, leaning, or pulling, try one before
deciding to buy one—some people find them difficult to use.
Talk to your doctor or the certified fitter at
your medical supply store about any difficulties you might have with your
compression stockings. Call your doctor if your toes get numb or painful or
turn dark while you are wearing compression stockings.
Every day,
have your stockings at your bedside, ready to put them on before you get out of
bed. After you've mastered the technique, you'll find this becomes a regular
part of your daily routine. If your stockings are properly fitted, they should
feel comfortable when you have them on.
Consider buying two pairs of stockings, and alternate them daily.
Test Your Knowledge
Compression stockings should be loose enough to pull
up like a sock.
- True
This answer is incorrect.Compression stockings are meant to be quite
snug. In fact, they are available in different levels of compression for
different kinds of physical problems. Those meant for preventing varicose
veins, available without a prescription, are less snug than prescription
stockings for preventing venous skin ulcers.
- False
This answer is correct.Compression stockings are meant to be quite
snug. In fact, they are available in different levels of compression for
different kinds of physical problems. Those meant for preventing varicose
veins, available without a prescription, are less snug than prescription
stockings for preventing venous skin ulcers.
-
Continue to Where?
Now that you have read this
information, you are ready to take an active part in your treatment by wearing
compression stockings on a daily basis.
Talk with your doctor or medical supply store certified fitter about any problems you have with your compression stockings. The risk of going without compression treatment is too great to neglect wearing them.
Take your stockings and anything you use to put them on with you when you
visit your doctor. If you have questions about this information, take it with
you when you visit your doctor. You may want to use a highlighter to mark areas
or make notes in the margins of pages where you have questions.
You can find more information about vein, circulation,
and skin ulcer problems in these topics:
Return to topic:
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
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| Specialist Medical Reviewer | Margaret Doucette, DO - Physical Medicine and Rehabilitation, Wound Care, Hyperbaric Medicine |
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| Last Revised | September 29, 2009 |
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Last Revised:
September 29, 2009
Seton is proud to have four hospitals – the only hospitals in Central Texas - that have earned the Magnet designation, the highest award for nursing excellence given by the American Nurses Association.