Graded compression stockings: custom vs noncustom.

Graded compression stockings of the leg (high pressure at the ankle and low pressure at the thigh) seem to help the return of venous blood to the heart and reduce the incidence deep-vein thrombosis and pulmonary emboli in supine patients. Recent advances allow noncustom stockings to be chosen for mesomorphic patients by leg length and calf circumference yet deliver the desired level of graded compression. To test the hypothesis that custom-tailored and noncustom, low-modulus. circular-knit stockings are equally efficient, a Doppler instrument and recorder were used to continually monitor femoral-vein velocity both when the patient had the stocking on and after it was removed. The changes in venous velocity after removal of custom and noncustom stockings were similar (-19% and -27%, respectively). In the five patients with whom both types of stocking were evaluated, the changes were -24% for custom and -22% for noncustom stockings. Using Laplace's law and measuring the tension created by a given stretch (circumference), low-modulus stockings were shown to deliver a more uniform pressure over a greater range of leg circumference than did high-modulus stockings. These results justify the use of noncustom, low-modulus, circular-knit elastic stockings to increase femoral-vein velocity in supine, mesomorphic patients.