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Compression stockings - Management
What assessment should I carry out before prescribing compression stockings?

  • Exclude arterial insufficiency:
    • Measure the ankle-brachial pressure index (ABPI) using a Doppler machine (some experts suggest that this is unnecessary if foot pulses are easily palpable, the person has no symptoms of arterial disease, and strong compression is not being applied).
      • ABPI less than 0.5: compression stockings should not be worn, as severe arterial disease is likely.
      • ABPI between 0.5 and 0.8: apply no more than light (class 1) compression, as arterial disease is likely and compression may further compromise arterial blood supply.
      • ABPI greater than 0.8: compression stockings are safe to wear.
      • ABPI greater than 1.3: avoid compression, as high ABPI values may be due to calcified and incompressible arteries. Consider seeking a specialist vascular assessment.
  • Check the condition of the skin:
    • Fragile skin may be damaged while trying to put on or take off compression stockings.
    • Ideally, venous ulcers should be healed before using compression stockings.
  • Consider whether the person is likely to be able to manage compression stockings:
    • Conditions such as arthritis, especially in older people, may make it difficult for the person to put on or take off stockings.
    • If the person is likely to have difficulty, an application aid may be helpful, or support from community nursing staff may be needed.

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