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Warning over poor stocking use

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Many surgical patients are at increased risk of developing deep-vein thrombosis (DVT) because they are not wearing compression stockings correctly, say US researchers.

They said there was an abundance of evidence to show that graduated compression stockings – when fitted and used correctly – significantly reduced DVT risk by promoting venous blood flow in the legs. But if used incorrectly, they offered no protection and could cause severe discomfort and skin breakdown.

The researchers assessed the skin and measured the legs of 142 hospitalised post-operative patients who had been prescribed either thigh-length or knee-length compression stockings.

They then compared these measurements with a manufacturer’s sizing chart to determine whether the correct size stockings had been applied and also observed how they were fitted.

More than a quarter of the patients were wearing the wrong sized stockings and almost a third were wearing them incorrectly, the authors found. Stockings were rolled down, wrinkled, too loose or too tight, they said, with thigh-length stockings causing the most discomfort.

The fact that 20% of the patients did not actually understand why they were wearing the stockings probably contributed to this incorrect usage, they added.

‘We recommend that knee-length stockings be the standard length used and that the education of nurses and patients about the proper use of stockings be improved,’ said lead author Elizabeth Winslow, research consultant at the Presbyterian Hospital
of Dallas in Texas.

Sue King, director of nursing at the South West London Elective Orthopaedic Centre, said: ‘It is vital that nurses are taught how to specifically measure patients’ legs to fit stockings correctly and that patients are aware why they are using them. If not, they can do more harm than good.

‘A representative from the company supplying the stockings is usually more than happy to hold teaching sessions – so if you are unsure, make sure you contact them,’ she added.

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