Compression Therapy after Sclerotherapy.

Hello, my name is Mandy Wright and I'm CEO of GuardMed Limited. The title of the presentation today is Compression Therapy. The key topics for discussion are What is compression therapy? How does compression therapy work? Compression values explained Indications for compression Types of compression How to measure and select the correct stockings GloriaMed stockings compression after sclerotherapy and then there's a brief conclusion. So compression therapy is the application of a controlled pressure applied to the surface of the vein which keeps the vein diameter small and forces blood back into the deep vein system and this in turn pushes the blood up towards the heart. Varicose veins are caused by weak vein walls or valves so when the vein walls weaken they loosen in their elasticity and the valves no longer close. Blood flows backwards and causes veins to bulge. When compression is applied to the legs, this squeezes the vein walls together and allows the valves to work correctly. When we stand upright, venous pressure is highest at the ankle or foot, so the amount of pressure that needs to be applied is therefore higher at the ankle. Graduated compression means that the pressure exerted by the stockings on the leg decreases gradually and proportionately from the bottom of the stocking to the top. The amount of compression provided by the stockings is measured in millimetre mercury. To give you an idea, if you stand in one metre of water, the pressure at your ankle is around 70 millimetre mercury. Medical compression stockings are manufactured according to international standards and that could be either RAL standard which is the German standard which is considered the highest classification achievable for a medical stocking and then we also have the British standard. So there are four classes of RAL standard medical compression stockings. There's class 1 which provides 18 to 21 millimeter mercury, class 2 23 to 32 millimeter mercury, class 3 34 to 46 millimeter mercury and class 4 is above 46 millimeter mercury. Indications for compression. Compression therapy has been shown to prevent the progression of chronic venous insufficiency. So chronic venous insufficiency can be classified according to the CEAP classification. Spider veins are classed C1 and their small superficial veins. A study in Scotland demonstrated that 88% of women and 79% of men have spider veins. Then we have varicose veins these are blue or green bulging veins these are classified as class 2 and between 15 and 20 percent of the adult population have visible varicose veins. Another 15 to 20 percent have hidden varicose veins that cannot be seen on the surface. Who should wear compression hosiery? Your GP can prescribe compression hosiery if you suffer from chronic venous insufficiency such as varicose veins edema or leg ulcers but basically everyone can benefit from wearing compression hosiery. They are recommended if you have heavy tired legs, to prevent varicose veins during pregnancy, anybody whose mother or grandmother had varicose veins, postclerotherapy to prevent deep vein thrombosis or if you spend long hours sitting or standing. Types of compression. There are lots of types of compression socks around. I'm just going to discuss medical devices. So medical compression. Our medical compression socks are well standard. The insertion of a weft yarn, the red stitch in the diagram, allows precise compression at every point along the whole leg. Weft is double covered and can be elastane, cotton or latex free rubber. They are highly elastic yarns that easily adapt to limb shape and they have a guaranteed compression life of six months. Then we also have the medical support. The compression is still precise and targeted but the stockings do not comply to the RAL standards and are produced only with knitting yarns, no weft stitch. The defined compression in the ankle decreases upwards. The support stockings are also more economical to manufacture. They're suitable for everyday wear. How to measure for compression. The Gloramed Micro or RAL standard medical compression stockings come in 24 off-the-shelf sizes. I'm going to show you how to measure for the thigh high stockings. So for the medical stockings we measure the ankle which is B below the knee D, the calf at the widest point which is C, G which is the top of the leg and then the length from the floor to the top of the leg. To give you an example if you have a 22 centimeter ankle you're then a size small then you measure the calf below the knee on top of the thigh if these four are for example 36, 35 and 52 respectively you would have a max which is an extra wide so small extra wide and then the length from the floor to the top of the leg if that's 83 then they're long so we need three measurements here. Lady Gloria on the other hand are a medical support stocking they do actually go up to between 20 and 30 millimeter mercury anyway but these are measured according to the weight and the height of the person so these are these are only available in six size. So the main goal of the treatment is always excellent patient results and patient satisfaction with the stockings. I'm just going to talk briefly about GloriaMed, these are the manufacturers. So this is a family-run business, it was set up in 1926, they're based on in Menaggia on Lake Como. GloriaMed have a CE mark and they also have RAL standard, they have ISO 9001 and ISO 13485. Compression after sclerotherapy. Wearing compression stockings for three weeks enhances the efficacy of sclerotherapy of leg telangiectasias by improving clinical vessel disappearance. So we always advise that after sclerotherapy that if you can wear compression stockings for 48 hours day and night and then if possible for 2-3 weeks during the day and you take them off at night. Consider wearing compression hosiery anyway to maintain healthy legs after the procedure. As many as 60% of the adult population have varicose or spider veins and 90% of spider veins are genetic. Thank you for listening. you