![]() ![]() “As long as the patient doesn’t have tremendously low outflow pressure into the extremity, I think it’s safe for them to wear compression hose,” he said. Armstrong offered a general guideline for when compression hosiery are appropriate. The prescription for compression hosiery in diabetic patients with PAD or PVD needs to come from a clinician. But if the patient never walks far or long enough for leg pain or cramps to set in, then claudication may not manifest. Some, but not all PAD and PVD sufferers, will show signs of intermittent claudication. Armstrong, DPM, MD, PhD, professor of surgery at the University of Arizona College of Medicine and director of Southern Arizona Limb Salvage Alliance (SALSA), both in Tucson. While it may seem obvious, PAD and PVD require consideration beyond a visibly swollen leg, said David G. Issues that need to be addressed when prescribing compression hosiery include proper diagnosis, accurate measurements, and, of course, patient compliance. And then there are patients with peripheral arterial disease (PAD) and peripheral vascular disease (PVD). At the other end are those who suffer from significant edema or venous leg ulcers who are candidates for prescription-strength compression stockings. At one end of the spectrum are patients who may benefit from support pantyhose for light pressure to prevent or reduce mild swelling, a condition that is not only uncomfortable but can delay wound healing in diabetic patients. Indeed, the application of compression stockings would seem to be fairly cut and dry: Take leg measurements, use the manufacturer’s guidelines for determining the level of compression, choose a style, and hand over to the patient.īut not all diabetic patients are created equal, and neither are compression stockings. Anything higher than 20 mmHg compression, patients should be custom measured by a physician, especially if they have peripheral arterial disease,” she said. “For diabetics, usually we use 15 to 20 mmHg compression for those with edema and 10 to 15 mmHg for those without. Marybeth Crane, MS, DPM, FACFAS, CWS, managing partner at Foot and Ankle Associates of North Texas in Grapevine, also follows a similarly streamlined model. That’s the simple but effective rule that works for Bill Meanwell, CPed, founder, CEO, and director of the International School of Pedorthics in Broken Arrow, OK. And then there’s the even more challenging issue of patient compliance.įit shoes in the afternoon and compression stockings in the morning. Proper selection and sizing of compression hosiery can be confusing, but both are essential for control of edema and management of more serious vascular conditions in patients with diabetes.
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