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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
Appears in following Topics:
Compression Therapy
Lymphedema - Introduction and Assessment
Lymphedema - Treatment and Emerging Strategies for Prevention