Changing attitudes towards compression treatment in real phlebology practice from 2012 to 2022

• Kravtsov P.F.
• Markin S.M.
• Artemova A.S.
• Vanyan G.N.

Abstract

Background. Compression therapy for the treatment of chronic vein disease is a common technique and has been used for more than a hundred years. In 2012 a questionnaire was presented to the medical practitioners about compression therapy in everyday phlebology practice. In 2022 a similar survey was repeated by the participants of the Actual Phlebology project.

Aim. To evaluate the change of attitude of phlebologists towards compression therapy in patients with chronic vein disease during a 10-year period.

Material and methods. In 2012 152 physicians aged 21 to 71 years were questioned about compression therapy in everyday phlebology practice. In 2022 211 phlebologists aged 24 to 69 years participated in the survey. Respondents answered 14 general questions. In response to the realities of phlebology, six questions were added in 2022 to guide the physicians’ attitudes towards compression therapy.

Results. Compression therapy is still very widespread in chronic and acute conditions of the lower extremity venous system and is very favourably received by the physician community. Between 2012 and 2022, there has been a significant change in preference for post-operative treatment. Whereas 10 years ago 70.4% of respondents preferred elastic bandages, in 2022, 77. 4% of phlebologists already used compression bandages. After stripping the percentage of phlebologists recommending compression stockings increased by 9.3% to 87.6% between 2012 and 2022.

Conclusion. The most versatile compression stocking in 2022 is compression class 2. In the 10 years between the surveys a clear trend towards a decrease in compression class and a decrease in the duration of compression therapy in phlebology patients was observed. Compression therapy has been and still is widely used in patients with chronic vein disease. Despite the lack of a wide evidence base, its accessibility, safety and efficacy are the basis of the positive image of this technique in the eyes of the modern phlebology community.

Keywords:compression therapy; compression stockings; chronic venous disease; acute venous thrombosis

References

1.     Lippi G., Favaloro E.J., Cervellin G. Prevention of venous thromboembolism: Focus on mechanical prophylaxis. Semin Thromb Hemost. 2011; 37 (3): 237–51. DOI: https://doi.org/10.1055/s-0031-1273088  Epub 2011 Mar 31. PMID: 21455858.

2.     Kamaev А.А., Bulatov V.L., Vakhrat’yan P.E., et al. Varicose vein. Flebologiya [Phlebology]. 2022; 16 (1): 41–108. DOI: https://doi.org/10.17116/flebo20221601141  (in Russian)

3.     Agus G.B., Allegra C., Antignani P.L., Arpaia G., Bianchini G., Bonadeo P., et al. Guidelines for the diagnosis and therapy of the vein and lymphatic disorders. Int Angiol. 2005; 24 (2): 107–68. PMID: 15997218.

4.     Nicolaides A., Kakkos S., Eklof B., Perrin M., Nelzen O., Neglen P., et al. Management of chronic venous disorders of the lower limbs – guidelines according to scientific evidence. Int Angiol. 2014; 33 (2): 87–208. PMID: 24780922.

5.     Wittens C., Davies A.H., Bækgaard N., Broholm R., Cavezzi A., Chastanet S., et al. Editor’s choice – management
of chronic venous disease: Clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2015; 49 (6): 678–737. DOI: https://doi.org/10.1016/j.ejvs.2015.02.007  Epub 2015 Apr 25. Erratum in: Eur J Vasc Endovasc Surg. 2020; 59 (3): 495. PMID: 25920631.

6.     Knight Nee Shingler S.L., Robertson L., Stewart M. Graduated compression stockings for the initial treatment
of varicose veins in people without venous ulceration. Cochrane Database Syst Rev. 2021; 7 (7): CD008819. DOI: https://doi.org/10.1002/14651858.CD008819.pub4  PMID: 34271595; PMCID: PMC8407251.

7.     Shi C., Dumville J.C., Cullum N., Connaughton E., Norman G. Compression bandages or stockings versus no compression for treating venous leg ulcers. Cochrane Database Syst. Rev. 2021; 7 (7): CD013397. DOI: https://doi.org/10.1002/14651858.CD013397.pub2  PMID: 34308565; PMCID: PMC8407020.

8.     Sapelkin S.V., Zolotukhin I.A. Compression therapy in real phlebological practice: the results of a survey among the participants in a conference of Russian association of phlebologists. Flebologiya [Phlebology]. 2013; 7 (4): 9–17. (in Russian)

9.     Sushkov S.A. Compressive therapy at chronic venous insufficiency. Novosti khirurgii [News of Surgery]. 2012; 20 (2): 105–17. (in Russian)

10. Ignatovich I.M., Bontsevich D.M., Maslyansky B.A. The application of compression therapy in patients with varicose veins of the lower extremities. Novosti khirurgii [News of Surgery]. 2021; 29 (3): 302–10. DOI: https://doi.org/10.18484/2305-0047.2021.3.302  (in Russian)

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