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In the adult population of western countries it is estimated that 40-50 per cent of men and 50-55 per cent of women will have some form of disorder with their veins in the lower leg.
Vein disorders can affect the small and large veins of the legs. Varicose veins affect the superficial veins of the legs and spider veins affect the small veins of the skin.
Varicose veins are painful and unsightly veins and people will seek treatment for pain relief and for cosmetic improvement of both conditions.
Blood clots in the deep veins (those veins deep inside the muscles of the leg) - deep vein thrombosis - cause swelling and distension putting extra pressure on the superficial veins closest to the skin.

 

What are varicose veins?

Varicose veins are enlarged veins that form beneath the skin surface. If the walls of the veins or valves are damaged the veins can dilate - varicose - and the valves will fail to close properly. When the body is in the upright position blood being transported to the heart is allowed to flow back down the leg (retrograde flow). This backward flow of blood can accumulate and stagnate in the lower leg veins stretching the veins, increasing the pressure in the superficial veins closest to the skin, and over time create swollen and twisted blood vessels that appear on the skin surface as blue, rope-like veins.

 

Initially, the person will notice their legs feel tired and ache, most notably after prolonged standing. Unless the pressure is reduced fluid will continue to collect in the feet and ankles causing them to swell. Extended periods, usually several months, of lower leg swelling alters the skin around the ankle, weakening the area and making it susceptible to skin break, which can form an ulcer (venous stasis ulcer).

 

What are spider veins?

Spider veins (telangiectasias) are small thin enlarged blood vessels (capillaries) that lie close to the surface of the skin and appear red or blue in colour. They may be short or may be connected in a spider web or cluster pattern. Spider veins can extend over large areas of skin, most commonly on the thighs, ankles and feet.

 

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Treatment

Graduated Compression

Applying compression to the leg by way of stockings helps to:

  • Reduce the abnormally (high) pressure in the veins by squeezing the fluid back into the large veins for transport back to the heart
  • Normalise blood flow in the veins
  • Reduce the swelling in the lower leg
  • Relieve the typical symptoms of tired and aching legs

Graduated compression means there is a higher pressure at the ankle and the pressure decreases up the leg. Graduated compression by medical grade stockings is also used after sclerotherapy (see below) or vein surgery. The arterial circulation must be checked prior to the wearing of compression stockings to ensure an adequate blood flow is present. Stockings must be worn daily to achieve the full benefits of compression.

 

Stockings (Hosiery)

Medical grade stockings are ready-to-wear - 'off-the-shelf' - or custom made. Ready to wear stockings are seamless and manufactured in various standard sizes and pressures e.g. Jobst Ultrasheer. Custom made-to-measure stockings are generally reserved for individuals with unusually shaped limbs, tall or short patients and lymphoedema patients. Measurements are taken at various points along the leg whether it be a below or above knee stocking.

Sclerotherapy

Sclerotherapy is the injection of a medication agent directly into the unwanted vein. The solution acts on the inner lining of the vein causing it to collapse and shrink preventing blood flow through the area. Within weeks the collapsed vein is absorbed by the body and becomes barely visible. Because there are so many veins in the legs blood flow redirects itself to another route back to the heart compensating for the sclerosed vein. A vein may be needed injecting more than once, depending on its size. Graduated stockings or bandages are applied after the procedure to help the collapsed vein stick together.

 

 

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Product Selection

JOBST# Medical LegWear - Graduated Compression Garments

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Related Links

How does blood circulate?

How do veins and valves work?

Classes and styles of compression stockings

Patient Assessment

 

 

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