Graduated-Compression

Elastic compression

This is the most ancient treatment for varicose and lymphatic disorders and their complications.  It is based on applying bandages to the lower limbs, effective in controlling swelling of the legs caused by venous and lymphatic insufficiency.  In modern times these bandages have been, in part, replaced by elastic stockings and supports. These products are key factors in preventing and treating venous disorders, lymphoedema and their complications. They are also crucial during post-operative medical therapy, sclerotherapy and to maintain results achieved by treatments to reduce oedemas caused by abnormalities in the lymphatic system. As preventive measures they delay or prevent the appearance of the disease. In advanced stages they reduce complications from ulcers and phlebitis. They prevent the formation of oedema and enhance “venous pump” effectiveness.

 muscular-calf-pump

Compression

Elastic stockings and supports for the limbs compress the superficial veins and microcirculation pushes the blood from the superficial veins into the deep venous axis which works normally. Reflux into superficial veins is reduced to virtually nothing, depending on the compression exerted by the support. This prevents problems of venous stasis or venous ulcers. This mechanism of action can be explained more simply by saying that elastic compression generates a real “pump effect”. Elastic compression is highly recommended in order to maintain results achieved following lymphatic drainage in cases of lymphoedema, preventing other fluid from accumulating and from increasing fibrosis over time. Compression (elastic compression in our case) is the force exerted by the tights or the support to compress the limb, facilitating the pump effect and helping blood and lymph circulation. Compression is measured at predetermined points and is expressed in millimeters of mercury (mmHg). Compression is clarified by specifying it to be graduated decreasing compression in the upwards direction. The highest compression value is at the ankle, called point B in medical language. The millimeters of mercury of compression indicated on the packages are measured at point B.

Classification of compression levels

GC-logoPreventive and therapeutic stockings, tights and supports are classified, regarding compression, in compliance with Experimental European Standard UNI ENV 12718. This standard replaces the tables of EC member countries which assigned different pressure values.

 
 

compression-points

CLASS A prevention
  • predisposed persons
  • swollen legs
  • telangiectasias
  • mild oedema 
 CLASS I light (L15-17 mmHg)
  • varicose veins
  • acrocyanosis
  • post-sclerotherapy of telangiectasias
CLASS I strong (H 18-21 mmHg)
  • truncal varicose veins
  • varicose veins with substantial oedema
  • post-varicectomy
  • post-sclerotherapy
  • arthrosis of the foot and knee
CLASS II (23-32 mmHg)
  • post-thrombotic syndrome
  • during treatment of ulcers
  • post-trauma treatment
  • angiodysplasias
  • deep venous thrombosis
  • deep venous insufficiency
  • reversible lymphoedema
  • lipoedema
CLASS III (34-46 mmHg)
  • severe oedema
  • chronic hypodermitis
  • irreversible lymphoedema
CLASS IV (>49 mmHg
  • for all the pathologies already listed and present in their most severe form
When not to use graduated compression

Graduated compression should not be used in the presence of the following pathologies:

  • arterial pathology: compression of small size arteries would further reduce blood passage, creating pain and reduced blood supply
  • diabetes with neuropathy (pain of peripheral nerves following alteration of glucose metabolism)
  • moist dermatosis (reddened skin, abraded surface, secretion of serous fluid)
  • ongoing skin ulcer (not caused by venous insufficiency)
  • crural eczema
  • disorders of arterial circulation
  • Raynaud’s disease arterial pathology with damage to the artery wall