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Level of compression for treating chronic venous disease

Level of compression for treating chronic venous disease
Level of compression Level of support Indication CEAP*
<15 mmHg (OTC) Minimal Asymptomatic individuals as needed for comfort 0,1
10 to 20 mmHg Mild Minor varicosities; tired, aching legs; minor ankle, leg, or foot swelling 1,2,3
20 to 30 mmHg Moderate Moderate to severe varicosities, moderate swelling, phlebitis, following vein ablation 3,4
30 to 40 mmHg Firm Severe varicosities, severe swelling, management of active ulceration, following DVT, post-surgery, mild lymphedema 4,5,6
40 to 50 mmHg[1,2] Very firm Moderate lymphedema NA
50 to 60 mmHg[1,2] Extra firm Severe lymphedema NA

The standard pressure gradients for compression hosiery are shown in the table.

Patients may have coexistant chronic venous disease and lymphedema.

For more severe lymphedema, compression garments are used to provide maintenance therapy following the first phase of complete decongestive therapy) to prevent fluid reaccumulation. The highest compression tolerated by the patient is likely to be the most beneficial.

DVT: deep vein thrombosis; NA: not applicable.

* Clinical-Etiologic-Anatomic-Physiologic classification of chronic venous disorders.

¶ OTC: over-the-counter, no prescription needed.
References:
  1. The diagnosis and treatment of peripheral lymphedema: 2020 Consensus Document of the International Society of Lymphology. Executive Committee of the International Society of Lymphology. Lymphology. 2020;53(1):3.
  2. Mosti G, Cavezzi A. Compression therapy in lymphedema: Between past and recent scientific data. Phlebology 2019; 34:515.
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