Information for Patients by Patients

Why Compression is Important for the Treatment and Prevention of Venous Leg Ulcers

What is a Venous Leg Ulcer?

A venous leg ulcer is a breakdown of the skin caused by problems with blood flow in the veins. A faulty vein valve cannot control the direction of blood flow.

What Does it Look Like?

The ulcer usually develops on the lower leg. It causes pain, itching, and swelling of the affected leg. The skin around the ulcer is often discoloured and thickened.

What Causes a Venous Leg Ulcer?

Venous leg ulcers can be caused by varicose veins, faulty valves in the veins under the skin, or Deep Vein Thrombosis (DVT). A venous leg ulcer is by far the most common type of leg ulcer, accounting for around 60-80% of all cases. Sometimes an ulcer happens in an area of varicose eczema or it follows a minor injury.

Why Do You Need Compression for Venous Leg Ulcers?

If you had a venous leg ulcer before or you’re at risk of developing one, your healthcare professional may recommend compression—sometimes bandages, sometimes stockings, socks, or Velcro wraparounds. Compression is specially designed to apply pressure to your lower legs, helping to maintain correct blood flow and reduce discomfort and swelling. It is usually tightest at the ankle and less tight further up your leg. This encourages blood to flow upwards towards your heart. There are plenty of studies and evidence that compression works, particularly for venous leg problems. Most leg ailments begin within the veins so helping the veins work more effectively is really beneficial.

How Do You Use Compression?

Compression socks and stockings come in a variety of sizes, lengths, and strengths of compression. Your legs need to be measured to see what size stockings you need, and a healthcare professional will check they fit properly and will ensure you are prescribed the right strength of compression. They can help you find a stocking that fits correctly and you can manage yourself. There are various accessories you can buy or be prescribed to help get the stockings on and off.

Compression Stockings help your blood to flow upwards to your heart. If you have been prescribed compression stockings/hosiery for a condition that affects your circulation, you may need to wear them for several years or, in some cases, the rest of your life. At the start, compression can feel uncomfortable, hot, and tight. Simple pain killers, such as those you take for a headache, can be useful but if this doesn’t help, speak to your healthcare professional. As swelling reduces, compression should be more comfortable. Evidence shows that the advantages far outweigh the discomfort.

Compression Bandages are sometimes used to start compression treatment. If you are prescribed compression bandages, these are often applied by a healthcare professional, but you (or a carer) may be able to apply them.

What Does Compression Mean to Those Who Use It?

I know compression can make an enormous difference to swelling and its resultant problems. Compression makes me feel excited, as I know it offers benefits.

Things to Remember When Wearing Compression Stockings

• Consult with a healthcare professional regarding how often and how long you need to wear them.
• Make sure to smooth out the stockings so they lie flat against the skin.
• Don’t bunch the compression stockings.
• Don’t fold or roll the tops down as it can make them too tight and could cause blood flow problems.
• Don’t cut the toe sections off as this will make them less effective.

You may experience some of the common problems with compression hosiery. These include rolling down or wrinkling around the ankle crease, which is because it moves around as you go about your normal day. You may possibly have skin irritation or damage while using the hosiery. If you have any queries, please refer to a healthcare professional.

Compression is meant to be tight—but not too tight! Tingling or numbness in the feet or toes, or swollen, pale, or ‘blue’ toes may indicate it is too tight—if this is the case, remove the compression and refer to your healthcare professional as soon as possible.

Compression was not half as bad as I thought it would be. I was terrified before but it has been brilliant! I don’t like wearing it as I don’t normally wear anything on my legs but I understand the need of wearing it. I wish I had known to wear compression as soon as I started to develop an ulcer. It could have stopped years of pain and suffering.

Useful Links

• NHS Website - Leg Ulcer
• Legs Matter
• Vascular Society - Patient Conditions
• NHS Website - How long should I wear compression stockings after surgery?
• NHS Website - How long should I wear compression stockings to improve my circulation?

Measuring should be done by a healthcare professional. Please refer to suppliers' information for how to put on and care for your specific type of compression hosiery.

Citylabs 1.0, Nelson Street, Manchester M13 9NQ

National Wound Care Strategy - A programme commissioned by NHS England