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Dallas researchers find most compression stockings are improperly used
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Graduated compression stockings, one of the tools used to prevent deep vein thrombosis (DVT) in hospitalized patients, are often incorrectly fitted, putting patients at risk for potentially deadly blood clots, according to researchers at Presbyterian Hospital of Dallas.
Their findings will appear in the September issue of the American Journal of Nursing.
Immobile patients are at increased risk for blood clots after surgery because blood tends to pool and coagulate in stationary extremities. These deep vein clots can travel to the lungs and block the pulmonary artery, resulting in a serious and sometimes-fatal complication called a pulmonary embolism, said lead author Elizabeth H. Winslow, PhD, RN, in a press release.
Despite the importance of graduated compression stockings, which use pressure to enhance blood flow in the legs, the devices are often used incorrectly, and patients often don't understand their importance, the researchers reported in the release.
"Problems with the use and sizing of graduated compression stockings are common throughout the country, and this study is one of the first to systematically analyze the problems and recommend ways to improve practice," Winslow said.
The Presbyterian Hospital researchers say knee-length stockings – not thigh-length – should be the standard size used and nurse and patient education should be improved. Thigh-length stockings are often improperly worn because they're uncomfortable and more cumbersome than knee-high versions, which are just as effective, said co-author Debra Brosz, MSN, RN.
"Compression stockings increase blood flow velocity and reduce the tendency of blood to coagulate," Brosz said, "but they have to be fitted correctly."
The researchers found that the stockings were used incorrectly in almost 30% of cases and were sized incorrectly 26% of the time, according to the press release.
Many studies conducted over the past three decades have shown that graduated compression stockings significantly reduce the rate of deep-vein thrombosis in postsurgical patients, according to the researchers.
"A lot can be done to optimize the benefits of graduated compression stockings and minimize adverse effects," Brosz said. "Knee-length stockings have many practical advantages over thigh-length stockings in that they lower the risk of problems and health care costs."