Benigni J P, Allaert F A, Desoutter P, Cohen-Solal G, Stalnikiewicz X
HIA Bégin, 69 avenue de Paris, Saint Mandé, France.
Perspect Vasc Surg Endovasc Ther. 2011 Dec;23(4):238-43. doi: 10.1177/1531003511431737. Epub 2012 Jan 11.
The use of a specific thigh foam pad placed under compression stockings increases interface pressure. The interface pressure obtained under 2 medical compression stockings of 15 to 20 mm Hg at the ankle, is 14 ± 2.2 mm Hg in the middle of the thigh in the horizontal position and rises to 49.2 ± 4.7 mm Hg when an appropriate thigh foam pad is interposed. Thigh compression could be useful in relieving pain after surgery of the great saphenous vein.
The aim of this study was to compare pain intensity on day 1 and day 7 and global mean pain during the week after stripping of the great saphenous vein between patients to whom a pad has been added at the thigh level under the compression stocking (case) and patients wearing a compression stocking only (control).
Case-control study conducted in daily surgical practice by patients having undergone surgical stripping. Main criteria: pain self-evaluation on visual analogue scale from day 1 to day 7 adjusted for analgesic consumption. No pain evaluation was conducted on Day 0 because of the fact that the elastic compression was applied in the operating room on a patient still under anesthesia. Results. A total of 53 patients were included in the study: 36 in the pad group and 17 in the control group. Patients were similar in respect of age, sex ratio, body mass index, professional status, and CEAP (clinical, etiologic, anatomic, and pathophysiologic) classification. On day 1, pain was 40.8 ± 20.8 in the control group and 27.4 ± 24.2 in the pad group (P = .05). On day 7, pain was 15.3 ± 13.4 in the control group and 3.7 ± 5.5 in the pad group (P < .0001). Global mean pain during the week after stripping surgery was 156.5 ± 80.6 in the control group and 80.1 ± 82.01 in the pad group (P < .0001).
The results of this case-control study show that the addition of a pad at thigh level under the elastic compression stocking significantly reduces pain experienced by patients during the week after stripping surgery by 49%.
在压力袜下放置特定的大腿泡沫垫会增加界面压力。在脚踝处施加15至20毫米汞柱的两种医用压力袜下，水平位置时大腿中部的界面压力为14±2.2毫米汞柱，当插入合适的大腿泡沫垫时，该压力会升至49.2±4.7毫米汞柱。大腿加压可能有助于缓解大隐静脉手术后的疼痛。
本研究的目的是比较在压力袜大腿部位添加垫子的患者（病例组）和仅穿压力袜的患者（对照组）在大隐静脉剥脱术后第1天和第7天的疼痛强度以及术后一周内的总体平均疼痛程度。
在日常外科手术实践中对接受手术剥脱的患者进行病例对照研究。主要标准：根据镇痛药物消耗量调整的第1天至第7天视觉模拟量表上的疼痛自我评估。由于在手术室对仍处于麻醉状态的患者施加了弹性加压，因此未在第0天进行疼痛评估。结果。本研究共纳入53例患者：垫子组36例，对照组17例。患者在年龄、性别比例、体重指数、职业状况和CEAP（临床、病因、解剖和病理生理）分类方面相似。第1天，对照组疼痛评分为40.8±20.8，垫子组为27.4±24.2（P = 0.05）。第7天，对照组疼痛评分为15.3±13.4，垫子组为3.7±5.5（P < 0.0001）。剥脱术后一周内的总体平均疼痛程度，对照组为156.5±80.6，垫子组为80.1±82.01（P < 0.0001）。
本病例对照研究结果表明，在弹性压力袜大腿部位添加垫子可使患者在剥脱术后一周内经历的疼痛显著减轻49%。
