[Learning Points]

1. Compression stockings are elastic socks that squeeze the legs. 
2. Precautions of wearing elastic stockings: Make sure that they are the correct size and degree of compression. If you do not know your size or required grade of compression, ask your health care provider and follow the manufacturer's instructions that come with the stockings. Make sure that they are clean, dry, and in good condition. Check them for rips and tears. Do not put them on if they are ripped or torn.

I. What do Medical Stockings do?

Compression stockings are elastic socks that squeeze the legs. They help increase blood flow (circulation) to the legs, decrease swelling in the legs, and reduce the chance of developing blood clots in the lower legs.

II. Wearing Notice for Varicose Veins Patients:

1. You need to wear elastic compression stockings for lifetime
2. You need to wear elastic compression stockings for at least six months; in case of the recurrent varicose vein, you will have to wear elastic compression stockings for lifetime
3. For patients of deep vein thrombosis, you should wear elastic stockings for at least six months
4. For patients of coronary artery surgery with saphenous vein graft harvested, you should wear elastic compression stockings for four to six months.
5. You have to wear it for all day except for bathing and sleeping.

III. Which type of compression stocking should I used?

The elastic stockings with progressive pressure have a higher pressure from the ankle and gradually reduce the pressure to the calf or thigh, so that the blood can be effectively compressed from the ankle to the thigh, and the blood circulation of the foot can be improved. When choosing elastic socks with progressive pressure, you need to pay attention to the contact pressure, material, length and size.

1. Contact pressure: Excessive pressure will cause poor blood circulation in the lower extremities and make the condition worse; according to the internationally certified progressive compression elastic stockings grade Compression Class/CCL, the pressure unit is millimeters of mercury (mmHg), different grades are suitable for related diseases.

   Indications	Compression class (CCL)/Pressure value ankle)
   1. Work requires standing 2. Mild varicose veins 3. Bedridden after surgery	1 degree of compression in: 18– 21mmHg
   1. Symptomatic varicose veins 2. Post varicose vein surgery 3. Deep thrombophlebitis 4. Deep vein thrombosis	2 degree of compression in mmHg: 23 – 32 mmHg
   1. Venous ulcer 2. Mild lymphedema	3 degree of compression in mmHg:34 – 46 mmHg
   Moderate or higher lymphedema	4 degree of compression in mmHg: >49 mmHg

    
2. Material: West German cotton elastic is soft and comfortable, Lycra elastic is harder; the higher the pressure level, thetighter it is, it is recommended to choose cotton material.
3. Length: Please choose the appropriate length according to the doctor's instructions (such as calf socks, thigh socks or pantyhose.
4. Size: According to the length type and the centimeter of the measuring point, provide it to the manufacturer and choose a comfortable size.

IV. Precautions of wearing elastic stockings

Make sure that they are the correct size and degree of compression. If you do not know your size or required grade of compression, ask your health care provider and follow the manufacturer's instructions that come with the stockings. Make sure that they are clean, dry, and in good condition. Check them for rips and tears. Do not put them on if they are ripped or torn.

V. Wearing Methods

1. When you get up in the morning, remember to put on your stockings before getting out of the bed.
2. Before wear stockings, lying flat on the bed, and raising your legs about 15-20cm in height, keep the posture for 15 minutes before wearing it.

• Step 1 Put your hand into the stocking and grab the "hosiery" part. After pulling, turn the elastic socks and socks over.

• Step 3 Put your hand into the stocking and grab the "hosiery" part. After pulling, turn the elastic socks and socks over.

• Step 4: Pull the elastic socks up step by step, and put on the elastic socks after putting them on Smoothing.

VI. Step off the elastic stockings

1. The method of removing the elastic stockings is just as important as the method of wearing.

• Step 1: Lying on the bed, to remove elastic stockings.
• Step 2: Using the blanket or pillow to raise legs higher than heart 15 to 20 cm, and keep 10 to 15 minutes.

VII. Washing Instructions:

1. When washing elastic stockings, use warm water and neutral soap or neutral detergent mixed with warm water washing at 40℃, then rinse with water.
2. When drying your elastic stockings, use a dry towel and put them in the shade to dry the water, do not wring and avoid direct sunlight.
3. No washing machine, dryer, or bleach on your elastic stockings; avoid using a hot iron or a hair dryer with hot air to dry them rapidly.

VIII. How to deal with an allergic reaction?

This is a normal situation if there are mild skin itching sensation, you can gradually increase the wearing time (for example: first time for fifteen minutes, the second time for an hour, until you can wear it whole day). You can put on lotion before wearing the elastic socks, if there is still allergy and need to consider changing the elastic stockings.

IX. Summary

Before wearing, you must follow the instructions of doctors and professionals to choose the correct size. Because progressive compression elastic stockings have high pressure, it is more difficult to wear than ordinary stockings. As long as you practice more and increase the number of wearing times, you can become familiar with it.

X. Reference

1. Dahm, K. T., Myrhaug, H. T., Strømme, H., Fure, B., & Brurberg, K. G. (2019). Effects of preventive use of compression stockings for elderly with chronic venous insufficiency and swollen legs: A systematic review and meta-analysis. BMC Geriatrics,19(1), 76. https://doi.org/10.1186/s12877-019-1087-1
2. Lozo, M., Penava, Ž., Lovričević, I., & Vrljičak, Z. (2022). The structure and compression of medical compression stockings.Materials 15(1), 353. https://doi.org/10.3390/ma15010353
3. Rother, U., Grussler, A., Griesbach, C., Almasi-Sperling, V., Lang, W., & Meyer, A. (2020). Safety of medical compression stockings in patients with diabetes mellitus or peripheral arterial disease. BMJ Open Diabetes Research & Care, 8(1), e001316. https://doi.org/10.1136/bmjdrc-2020-001316