Multicenter randomized trial comparing compression with elastic stocking versus bandage after surgery for varicose veins.
OBJECTIVE
Postoperative limb compression is widely used after venous surgery to prevent thromboembolism and to reduce hemorrhage, edema, hematoma, and pain. Only limited studies have been published regarding the most adequate postoperative compression therapy after varicose vein surgery. This study evaluated the effectiveness of a new stocking kit used for postoperative limb compression.


METHODS
The study compared the clinical practicability, ease to use, effectiveness, and safety of a postoperative stocking system (23 to 32 mmHg at the ankle) with compression bandages (control group). This prospective, randomized, open-label clinical trial, was performed in three Italian centers specializing in venous surgery. Sixty consecutive patients (classification CEAP C₂,(S)) underwent unilateral varicose vein surgery at one of the three centers. After surgery, patients were randomized for postoperative compression therapy with a new stocking system (Sigvaris Postoperative Kit; Ganzoni Sigvaris Corp, Winterthur, Switzerland) or standard stretch bandages (30 patients per group). Primary end points were incidence of venous thromboembolism, hemorrhage, limb hematoma, or edema.


RESULTS
No episodes of venous thromboembolism were observed. The mean area of thigh hematoma on postoperative days 7 and 14 was 75.70 cm² and 2.93 cm², respectively, for the stocking group, and 92.97 cm² and 5.42 cm² for the bandage group (not significant). On postoperative day 7, edema was found in 50% of the patients wearing bandages and in 20% of the patients wearing the stocking kit, which was a significant reduction. No statistical difference was recorded for postoperative pain; however, better patient acceptance and quality of life after the operation were recorded in the stocking group.


CONCLUSIONS
Patients can be effectively treated with the Sigvaris Postoperative Kit. Patients treated with stockings have less edema compared with standard bandaging, and the application of the stocking kit improves patient quality of life and compliance with postoperative compression therapy.
Department of General Surgery, University of Siena, Siena, Italy. brtma@tin.it
Fabrizio
F
Mariani
Enrico Maria
EM
Marone
Vincenzo
V
Gasbarro
Matteo
M
Bucalossi
Sara
S
Spelta
Felix
F
Amsler
Michele
M
Agnati
Roberto
R
Chiesa
D000293:Adolescent; D000328:Adult; D000368:Aged; D058128:Compression Bandages; D004487:Edema / Q000601:surgery; D005260:Female; D006406:Hematoma / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D053828:Stockings, Compression; D013923:Thromboembolism / Q000517:prevention & control*; D016896:Treatment Outcome; D014648:Varicose Veins / Q000601:surgery*; D055815:Young Adult