Rabe E, Partsch H, Hafner J, Lattimer C, Mosti G, Neumann M, Urbanek T, Huebner M, Gaillard S, Carpentier P, et al.
Phlebology. Date of publication 2018 Apr 1;volume 33(3):163-184.
1. Phlebology. 2018 Apr;33(3):163-184. doi: 10.1177/0268355516689631. Epub 2017 Feb
22.
Indications for medical compression stockings in venous and lymphatic disorders:
An evidence-based consensus statement.
Rabe E(1), Partsch H(2), Hafner J(3), Lattimer C(4), Mosti G(5), Neumann M(6),
Urbanek T(7), Huebner M(8), Gaillard S(9), Carpentier P(10).
Author information:
(1)1 Department of Dermatology, University of Bonn, Bonn, Germany.
(2)2 Department of Dermatology, Medical University of Vienna, Austria.
(3)3 Department of Dermatology, University Hospital of Zurich, Zurich,
Switzerland.
(4)4 Josef Pflug Vascular Laboratory, West London Vascular and Interventional
Centre, Ealing Hospital & Imperial College, London, UK.
(5)5 Angiology Department, Clinica MD Barbantini, Lucca, Italy.
(6)6 Department of Dermatology, Erasmus University Hospital, Rotterdam, The
Netherlands.
(7)7 Medical University of Silesia Department of General Surgery, Vascular
Surgery, Angiology and Phlebology, Katowice, Poland.
(8)8 SIGVARIS AG, St Gallen, Switzerland.
(9)9 SIGVARIS Management AG, Winterthur, Switzerland.
(10)10 Centre de Recherche Universitaire de La Léchère, Equipe THEMAS, Université
Joseph Fourier, Grenoble, France.
Objective Medical compression stockings are a standard, non-invasive treatment
option for all venous and lymphatic diseases. The aim of this consensus document
is to provide up-to-date recommendations and evidence grading on the indications
for treatment, based on evidence accumulated during the past decade, under the
auspices of the International Compression Club. Methods A systematic literature
review was conducted and, using PRISMA guidelines, 51 relevant publications were
selected for an evidence-based analysis of an initial 2407 unrefined results. Key
search terms included: 'acute', CEAP', 'chronic', 'compression stockings',
'compression therapy', 'lymph', 'lymphatic disease', 'vein' and 'venous disease'.
Evidence extracted from the publications was graded initially by the panel
members individually and then refined at the consensus meeting. Results Based on
the current evidence, 25 recommendations for chronic and acute venous disorders
were made. Of these, 24 recommendations were graded as: Grade 1A (n = 4), 1B
(n = 13), 1C (n = 2), 2B (n = 4) and 2C (n = 1). The panel members found
moderately robust evidence for medical compression stockings in patients with
venous symptoms and prevention and treatment of venous oedema. Robust evidence
was found for prevention and treatment of venous leg ulcers. Recommendations for
stocking-use after great saphenous vein interventions were limited to the first
post-interventional week. No randomised clinical trials are available that
document a prophylactic effect of medical compression stockings on the
progression of chronic venous disease (CVD). In acute deep vein thrombosis,
immediate compression is recommended to reduce pain and swelling. Despite
conflicting results from a recent study to prevent post-thrombotic syndrome,
medical compression stockings are still recommended. In thromboprophylaxis, the
role of stockings in addition to anticoagulation is limited. For the maintenance
phase of lymphoedema management, compression stockings are the most important
intervention. Conclusion The beneficial value of applying compression stockings
in the treatment of venous and lymphatic disease is supported by this document,
with 19/25 recommendations rated as Grade 1 evidence. For recommendations rated
with Grade 2 level of evidence, further studies are needed.
DOI: 10.1177/0268355516689631
PMCID: PMC5846867
PMID: 28549402
