Compression Stockings …. what are they good for ….

“Don’t forget your stockings …..!!”

Many of us have been there. You’re on the hospital trolley; the nurses have given you a shot of something akin to a very large G&T in the arm. You start to relax. The forthcoming elective surgery now feels less daunting. Then they lift your legs and ‘delicately’ slip on a pair of, not overly attractive stockings…! Now ‘everything’ is good to go ….!

On the 12th April 2011, Paul Westerman quite literally dropped down dead. He’d suffered a massive bilateral pulmonary embolism. A DVT had started in his lower right leg after an innocuous knee injury 2 weeks beforehand. His leg strapped up in a brace and wearing Graduated Compression Stockings, he should have been safe – or so he was led to believe.

For decades, Graduated Compression Stockings have been a constant aspect of patient care and treatment within the NHS and the wider medical sector. Whether post-surgery, in maternity, in ICU, or throughout long-term hospitalisation, the NHS has relied upon the GCS as a form of DVT prevention. At present the compression stockings market is substantial, valued at £1.6 billion in 2018, and expected to reach £2.4 billion by 2026.

But how effective are these stockings? Do they protect patients from the threat of developing blood clots?

Research has recently been undertaken by GAPS (Graduated Compression Stockings as adjuvant to pharmaco-thromboprophylaxis in elective surgical patients  (GAPS study): randomised controlled trial. (Published in the  BMJ – BMJ 2020; 369 doi: Published 13 May 2020.  BMJ 2020;369:m1309)

The studies were undertaken at Imperial College Healthcare NHS Trust, Cambridge University Hospitals NHS Foundation Trust, University Hospital Southampton, Guy’s and St Thomas’ NHS Foundation Trust, Salisbury NHS Foundation, Heart of England NHS Foundation Trust and Portsmouth Hospitals NHS Trust.

The conclusion of the research states that; “findings indicate that Graduated Compression Stockings are unnecessary in most patients undergoing elective surgery.”

At the moment, Graduated Compression Stockings are recommended in many medical settings. Patients with diseases such as chronic venous insufficiency, deep vein thrombosis and lymphedema, which are common worldwide, are encouraged to wear them. There have long been doubts around their value. 

Paul Westerman, Director of RBR Active™, states that an increasing concern within the medical community is the sharp increase in sedentary lifestyles; Paul said “increasingly sedentary lifestyles have been reported to be a major cause of Deep Vein Thrombosis (DVT) and similar venous disorders. Every year, over 2 million deaths are attributable to a sedentary lifestyle. Whether we’re working from home more (as in the present COVID19 pandemic crisis); binge-watching Netflix box-sets or gaming on-line for hours, our sedentary lifestyles are quite literally killing us. As a preventive measure, people have been using compression garments, including compression socks, as a therapy or as a precautionary measure.”

This increase in sedentary lifestyles, was first discussed in the research papers by RBR Active’s™ Professor Richard Beasley of the MRINZ. Professor Beasley’s research shows that after being seated for just over an hour, blood flow to the lower limbs has fallen by over 50% – this decrease in blood flow to the lower limbs, significantly increases the threat of the patient developing a DVT (Deep Vein Thrombosis). 

What does this mean going forward? Graduated Compression Stockings are used in a multitude of other environments; care homes, airline passengers, desk workers, physiotherapy, sport, gamers, those in call centres. 

How will patients, residents, employees, airline passengers or those less mobile be made safe from developing a DVT in the future? If Graduated Compression Stockings are, as has been concluded, inefficient for those that need support, what is the answer?

RBR Active™ know that a proven solution is available now. The RBR Legflow™ created through the research of Professor Richard Beasley and his team at the MRINZ, increases blood flow to the lower limbs by over 10-fold. By supporting and increasing the body’s natural circulatory processes the RBR Legflow™ greatly improves circulation and this is what is key to protecting yourself from developing a Deep Vein Thrombosis.

Key facts:

  • During sustained periods of immobility, like flying, the combined effects of venous pooling, reduced flow create the conditions necessary for thrombus activation
  • The cost of thrombosis to the NHS is estimated at over £200 million a year
  • Globally this is a cost to health service providers of more than £22 billion each year
  • More than 60% of all cases of VTE are associated with hospitalisation, with many events occurring up to 90 days after admission
  • VTE affects approximately one in 1000 of the UK population and is a significant cause of mortality, long-term disability and chronic ill-health problems
  • In Europe, there are 544,000 VTE-related deaths every year
  • In the U.S. and Europe, VTE-related events kill more people than AIDS, breast cancer, prostate cancer and motor vehicle crashes combined 
  • In the UK, up to 60% of VTE cases occur during or after hospitalisation, making it the leading preventable cause of hospital death 
  • Hospital-acquired blood clots cause an estimated 25,000 preventable deaths each year  

Risk Factors for DVT

Older Age                                Immobility                               Obesity

Medical History                      Pregnancy                                HRT

Surgery                                    Hospitalisation                        Oral Contraceptives

Long-Haul Travel                     Cancer                                      Trauma

Just some of the thoughts in relation to the recent research being published.