• Elizabeth H Winslow and Debra L Brosz.
• Presbyterian Hospital of Dallas, USA. elizabethwinslow@texashealth.org
• Am J Nurs. 2008 Sep 1;108(9):40-50; quiz 50-1.

ObjectiveGraduated compression stockings, when used correctly, have been shown to significantly reduce the risk of deep-vein thrombosis in surgical patients, but they can be harmful to skin and may even increase the risk of thrombosis if the wrong size is used. The authors sought to determine whether nurses correctly size and apply the stockings, whether problems were more common in knee- or thigh-length stockings, and whether nurses adequately educate patients on the usage of the stockings.MethodsThe researchers used a comparative, descriptive design to study 142 hospitalized postoperative patients; 37 had thigh-length and 105 had knee-length stockings. They assessed usage of the stockings and compared four separate leg measurements against the manufacturer's sizing chart to determine whether stockings that had been applied were the correct size. They also asked patients to rate the comfort of the stockings and to describe their purpose.ResultsThe graduated compression stockings were used incorrectly (for example, they were wrinkled or the gusset was in the wrong place) in 29% of the patients and sized incorrectly in 26% of the patients. These problems were more common with the thigh-length stockings and in overweight patients. More patients who had thigh-length stockings found them uncomfortable than did those who had knee-length stockings, and 20% of patients didn't understand the stockings' purpose.ConclusionsThe authors recommend that nurses ensure that graduated compression stockings are properly sized and used, that the education of both nurses and patients regarding the stockings be improved, and that knee-length stockings be the standard length used.

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