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Principles of Compression Therapy

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Concept

The concept of compression therapy lies on a simple and efficient mechanical principle : the application of an elastic garment around the leg.

By compressing the limb with graduated compression - strongest at the ankle and decreasing going up the leg - the compression stocking helps the venous return, decreases venous pressure, prevents venous stasis and deterioration of venous walls, and efficiently relieves aching and heavy legs by aiding the body moving blood up the leg against the pull of gravity.

This treatment is prescribed by a physician to treat phlebitis, thrombosis and aftercare following surgery, sclerotherapy and any other forms of varicose vein treatment, and also to relieve all conditions of chronic venous disease (heavy legs, varicose veins, edemas, leg ulcers). It can also be prescribed to prevent venous issues during pregnancy and long distance travel. If no contraindications like severe arterial insufficiency are present, compression stockings of lower pressure can be purchased without prescription.

Depending on the pathology, medical compression therapy can be applied in different forms : socks, stockings, pantyhose or bandages.

The current new textures and fashion designs of SIGVARIS® compression products encourage better patient compliance.

Principles

  1. The principle of this therapy is to exert a controlled pressure on the limb The pressure unit is the millimeter of mercury (mmHg) or the hecto Pascal (hPa). 1 mmHg = 1.33 hPa.
  2. The pressure is exerted by the application of a device on the limb Stockings or bandages are called medical devices. They must meet strict requirements. The devices are called ortheses meaning that their action is to support or to reinforce a part of the human body, and not to be a subtitute like a prosthesis does.
  3. The action of the device is mechanical It utilizes the principle of hysteresis that is defined by the stretch-relaxation curve of an elastic body. The transmission of the pressure to the vascular system by those devices is indirect.
  4. The principle stands against the hyperpressure induced by a defective venous system. References : Pollack A.A. et Wood E.H. Venous pressure in the saphenous vein at the ankle in man during exercise and changes in posture. J Appl Physicl. 1949,1: 649. AND Partsch H., Rabe E., Stemmer R. Compression. Chapter 5. In: Compression of the extremities. Editions Phlébologiques Françaises. 2000. Paris. Pages 57-134.
  5. The pressure is stronger at ankle level The compression device must exert a contra-pressure where the pressure level is the strongest : at the ankle.
  6. The pressure is degressive The direction of the blood stream must be respected. Therefore the pressure must be dregressive. The gradually pressure decrease is defined in the requirements of the devices, and depends on the compression classes.
  7. The pressure is determined by: a) The elastic recoil force of the hosiery; b) The form of the leg : The pressure exerted on the leg depends on the curvature of the local surface (Laplace Law). Thus, a given stocking exerts a higher pressure above the tibial edge and the Achilles tendon and a lower one at the lateral aspect of the leg. Between ankle and Achilles tendon, no pressure is exerted as the garment does not touch the skin.

 Effects of compression

1. Hemodynamics effect

  • Increase venous blood flow
  • Decrease venous blood volume
  • Reduce pathological reflux in diseased superficial and/or deep veins
  • Reduce a pathologically elevated venous pressure

 2. Effect on tissue

  • Reduce an elevated water content of the tissue
  • Increase the drainage of waste products
  • Reduce inflammation
  • Sustain reparative processes
  • Improve movement of tendons and joints

What's compression therapy?

Principle and effects of compression

The concept of compression therapy is based on a simple and efficient mechanical principle consisting of applying an elastic garment around the leg. By compressing the limb with graduated compression (strongest at the ankle and decreasing going up the leg), the compression stocking acts as a layer of muscle by gently squeezing the stretched vein walls together, allowing the valves to close. The cavity of the vein is reduced, thereby restoring blood flow to a normal state and aiding overall circulation. Compression socks and stockings help the venous return, decrease venous pressure, prevent venous stasis and impair of venous walls, and efficiently relieve aching and heavy legs.

Indications and Contraindications

This treatment is prescribed by a physician to treat phlebitis, thrombosis, post vein surgery, and to relieve all manifestations of chronic venous disease (heavy legs, varicose veins, edema, leg ulcers..). It can also be prescribed to prevent venous troubles during pregnancy and long distance travel. Contraindications are limited: advanced peripheral obstructive arterial disease, severe uncontrolled congestive heart failure, septic phlebitis, oozing dermatitis, advanced peripheral neuropathy. Very few cases of allergy have been reported to one of the components.  There are no secondary effects with compression therapy treatment when manufacturer's sizing chart is strictly followed.

Compression levels

Compression stockings are available in different degrees of compression depending on the severity of the pathology to be treated (see Indications). The pressure exerted by a compression stocking at ankle level is measured in millimeters of mercury (mmHg). Compression levels or classes are defined according to different official norms (AFNOR in France, GZG in Germany). The physician prescribes the compression level corresponding to the pathology of the patient. 

Treatment dispensation

Depending on the pathology, medical compression therapy can be applied in different forms: socks, stockings (calf or thigh-length), pantyhoses, sleeves. The current new textures and fashion designs of SIGVARIS® compression products make compliance with the treatment much better and effective. As worldwide leading specialist in compression therapy, SIGVARIS® provides hightech state-of-the-art products combining high quality yarns and product development, proven medical efficacy, comfort and fashion.

What is a compression stocking?

To develop and produce highly efficient and esthetical medical stockings is to combine medical research and the latest technologies in the textile intelligence field. Know-how that SIGVARIS has been building through its 50 years of experience, and a permanent closeness to the medical community and the patients. Thus, our will and commitment to personalize our products to adapt the stocking to the patient's legs becomes the daily challenge of our developers and designers worldwide. SIGVARIS medical stockings combine functionality, esthetic and proven efficiency.

Manufacturing process

A medical stocking is made of a loop and of an inlaid yarn. The inlaid yarn is a textile-covered synthetic elastic yarn (covered yarn) that is incorporated into the loop. 
The specific know-how in the configuration of the covered yarns will define the quality of the medical stocking. The dosage of pressure level is defined by the covered yarn. A specific yarn caliber is selected to obtain the desired pressure dosage of the medical stocking.