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Research on TEDS: Lancet 27th May 2009

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Josephine

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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.
 
Interesting. Four and a half years ago, I started swelling. They told me first it was "cortisol" (as in, stress-induced), then they told me it was peri-menopausal, then eventually due to my two-decades of thyroid disease (diagnosed at 18, been on synthroid in varying doses ever since) and even after that they just called it "unexplained edema". I'd swell daily, sometimes just in the legs, sometimes all over (and I'd have to change out of jeans into track pants). The VA doctors gave me heart-patient compression stockings (knee-high). They succeeded in keeping the swelling above the knee (which defeated the whole purpose in my mind).

Anywhoo, in the hospital following my TKR in March, they had these inflatable boot things on my legs that were much more comfortable than the standard stockings. I liked them- they "hugged" my lower legs in sections, starting at the bottom and going up; then reversing as they de-flated. The rhythmic hissing of the air compressor thingy was also soothing. I asked if they'd notice if I smuggled the contraption home with me. ;)

Since my TKR, though, the only swelling I've had is related to the surgery itself. The four-year-long edema left as mysteriously as it appeared.

I've rambled on enough- the article was interesting though. I'm going to print it up and take it to show my parents today.
 
Frog feathers,
I have used the same type of bootie or calf compression automatic thingies after all my surgeries as well. I was so lucky to never have been sent home with the dreaded TED's.
Also have had high cortisol problems, swelling problems etc. I am glad yours seems to have disappeared. Mine seems to come and go. I have been diagnosed with hypopituitarism which messes up the whole endocrine system. Not fun , but surely not the worst scenario!!!!
judy
 
Interesting article, Jo. However, I'm not sure I'm thrilled to know I suffered through those stockings for....NOTHING!!! They are so expensive, though, I can see why it would be a good thing to discontinue if they really are not helping to prevent blood clots.
 
:hissy:and I wore that thing WHY!!!!!!!:hissy:

Just kidding I know my doctor felt it was important so I did it but I have to say I cheated several days.

There is no way something pinching you knee leg and toes can be good for you. It looked like I had a string around me in some places when I took it off.

I bet most doctors will still require you wear them
 
So the 2 pairs i have sitting in my dresser can go out in the trash?
 
Well I was the one who would wear those goffy things. People complimented me all the time (yeah right)Get with shorts in 95 degree weather. A kinda fashion statement. I was so faithfull that it looked like I took them out side and scrapped them on the concrete........
 
Not a problem over here in Australia at the moment.....its a bit cool (not cold by "cold" standards)....anyway under my regular socks they keep you nice and snug and warm....I'm glad I'm not wearing them in January when it hits 40 degrees celcius in the shade!
rachel
 
So the 2 pairs i have sitting in my dresser can go out in the trash?

Oh no, no....don't get rid of them....think of creative things to do with them. I hang mine with onions in them. How about using one a a dog leash (they are soooo tough). Or maybe you could cut them to tie up your 'maters in the garden. Oh my....there must be loads of things to do with old TEDS........NOT!!! I think it's a cruel joke to everyone who had to endure them to now say they don't do the job. Isn't that the way it goes? Sigh.........:sigh:
 
:rant: I hate those things!

I actually bought some to take to the hospital (2x--I have large calves) and i wore them overnight and they cut huge grooves in my leg. Needless they came off VERY quckly!

Glad to hear that someone continues to evaluate these kinds of things.

I actually sent the info to my OS!
Barb
 
There you go!!! Or braid them and have white headbands! Oh, the possibilities are endless.
 
You guys are so funny with your ideas. I never thought about. Onions, pot holders......Head bands, we could make a trend I..lol.hahahah....
 
I hate to tell all of you this but if you read the middle of the article in Lancet -- it says the stockings are still recommended for surgical patients. And that the date which resulted in the guidelines for stroke patients came from surgical patients. Meaning us. So I don't think we joint replacement folks are off the hook yet.....
 
So the 2 pairs i have sitting in my dresser can go out in the trash?
Mine are black and I use them when I dress up for the Renassaince Faire- they look like the stockings the ren-faire ladies wear and they hold everything in, giving my leg a nice shape (as long as I don't show above the knee.)

With all the cleavage hanging out at the Ren Faire, a stockinged leg is quite a popular choice for the "oooh-la-la" factor.
:hehe:
 
We are all so full of imagination! And everyone seems to agree....TEDS suck!!! :)
 
Yes there is a lot of imagination around. Teds are the worst.
But bet some doctors will still use them. UGG
 
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