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Negative Research on TEDS: Lancet 27th May 2009

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This news appeared in the UK papers Wednesday, 27 May 2009.
Stockings 'no stroke clot help'

Surgical stockings do not cut stroke patients' risk of developing blood clots, research suggests.

Doctors commonly use the stockings as way to minimise the risk of clots forming and travelling to the lungs or heart, where they can be fatal. But a Lancet study, by the University of Edinburgh, found they had little positive effect. The team estimates cutting stocking use could save the NHS around £7m and 320,000 hours of nursing time a year.

It was previously thought the tight stockings helped to increase blood flow through the legs and reduce the formation of clots. Around two thirds of stroke patients are unable to walk on admission to hospital and approximately 15% develop blood clots because of this lack of movement. The Edinburgh team, whose work was partially funded by Chest, Heart & Stroke Scotland, studied over 2,500 stroke patients in the UK, Italy and Australia. All received routine care, including aspirin and assisted exercise, and half were offered surgical stockings as well.

After 30 days there was no significant difference in the blood clot rate in the two groups. However, the group given stockings experienced more skin breaks, ulcers and blisters than those without. Compression stockings are still recommended for patients who have undergone surgery and for people travelling on long-haul flights.

Call for new guidelines
Researcher Professor Martin Dennis said: "The guidelines on the use of these stockings have been based on evidence collected in surgical patients and not in stroke patients. "We have shown conclusively that compression stockings do not work for stroke patients. "The national guidelines need to be revised and we need further research to establish effective treatments for these patients.

"Abandoning this ineffective and sometimes uncomfortable treatment will free up valuable resources in our health services." Dr Peter Coleman, of the Stroke Association, said: "It is important that all treatments are carefully evaluated, and if studies show they are ineffective in stroke patients, we believe they should be discontinued. "It is still vital, however, that patients are carefully monitored after their stroke to ensure there are no further complications, and to ensure they receive the best possible treatment."

More than 150,000 people a year have a stroke in the UK.
 

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