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Deep vein thrombosis - prevention for travellers - Management
What advice should I give about graduated compression stockings?

  • Graduated compression stockings are recommended for people assessed as having a moderate or high risk of travel-related deep vein thrombosis (DVT).
    • Measure the ankle-brachial pressure index (ABPI) if the person has symptoms of arterial disease. If the ABPI is less than 0.5, compression stockings should not be worn.
    • For further information see the section on Assessment in the CKS topic on Compression stockings.
    • Advise the use of below-knee graduated stockings with an appropriate compression.
    • Class 1 stockings (exerting a pressure of 14–17 mmHg at the ankle) are generally sufficient.
    • However, for some people, a higher rating may be indicated to manage other conditions (such as oedema).
    • For further information on the use of compression stockings, see the CKS topic on Compression stockings.
  • Availability on prescription:
    • Compression stockings are not available on prescription for the sole indication of preventing travel-related DVT.
    • However, they can be prescribed for people with certain indications.
    • For people who require a pair of class 1 graduated compression stockings (with a cost of two prescription charges) who are not exempt from prescription charges, advise that it might be cheaper to buy proprietary flight socks over-the-counter.
  • Proprietary flight socks:
    • These are widely available from pharmacies, airports, and many retail outlets.
    • They provide a compression of 14–17 mmHg at the ankle (equivalent to class 1 stockings). However, flight socks with higher ratings (18–21 mmHg, similar to class 2 stockings) are also available.
    • Stress the importance of ensuring that the socks are correctly fitted to provide adequate compression.
      • This is particularly important in people with varicose veins, in whom there may be an increased risk of superficial thrombophlebitis.
    • If in doubt, advise the person to seek advice from an appropriate healthcare professional (for example a pharmacist).

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