Pressure differences of elastic compression stockings at the ankle region

Elastic compression stockings are widely used medical devices for the prevention of edema and treatment of venous diseases. Many beneficial effects have been described in the past. The exact amount of pressure underneath elastic compression stockings at different areas of the leg remains controversial.

To examine the pressure at the skin underneath class II elastic compression stockings at different places around the ankle at the B level.

Patients with known venous insufficiency and regularly using class II elastic therapeutic compression stockings (25-35 mm Hg) for venous diseases were included. All subjects were wearing completely new stockings at the time of the study. Measurements were performed with an electropneumatic interface pressure measuring device (Oxford Pressure Monitor MK II) with inflatable small sensoring cells. Six sensors were placed around the smallest circumference at the ankle (B-area). The highest and lowest recordings as well as the means were evaluated.

The mean pressure of class II elastic stockings measured around the ankle was 24.7 mm Hg (SD, 8.4). The lowest pressures were found at the medial site (18.3 mm Hg; 74% of the mean), and the highest at the pretibial zone (33.9 mm Hg, 137%).

The pressure exerted by pressure class II elastic compression stockings a the medial site just above the ankle (B area) is too low to have influence and improve the venous insufficiency. For phlebology this is the target area. It might be a reason for the high recurrence rate of venous ulcers even if patients wear stockings. Also, the mean pressure of class II stockings was found to be below the normal levels of its pressure class (25-35 mm Hg according to the European CEN classification). The results advocate the use of pressure class III elastic compression stocking more often and the use of pelottes or foam pads.