Effect of Compression Stockings on the Skin Microcirculation in Chronic Venous Insufficiency

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Abstract
To use a single fibre laser Doppler fluxmeter to assess the microcirculatory effects of compression stockings. Controlled study comprising patient and control groups. Department of Surgery, University College London Medical School, London, UK. Ten patients with lipodermatosclerosis caused by chronic venous insufficiency and 10 control subjects. Measurements were made from the liposclerotic skin of patients and 8 cm above the medial malleolus in controls. Laser Doppler flux (LDF), blood ce velocity (BCV) and concentration of moving blood cells (CMBC) were recorded with the subject lying supine. A class II graduated compression stocking was applied to the leg and laser Doppler recordings were repeated. The protocol was repeated with the subject sitting. The effects of a compression stocking on LDF, BCV and CMBC in the horizontal and sitting positions were measured. In patients in the supine position, the compression stocking resulted in a 28% median increase in LDF (p = 0.03), with a corresponding 29% median increase in BCV. There was no significant change in CMBC. In the sitting position, the compression stocking caused a 105% median increase in LDF (p < 0.01) due to a corresponding 89% median increase in BCV (p = 0.01); there was only 25% median increase in CMBC. The effects of compression in controls were similar to those in patients. Compression stockings may be effective in the treatment of chronic venous insufficiency by increasing the microcirculatory flow velocity.