TED hose or compression stockings - when should they be worn?

[BoneSmart]

Updated September 2, 2020 by Jamie

Although many people think Thrombo-Embolic Deterrent (TED) hose and compression stockings are pretty much the same thing, they are in fact two different types of compression products for use at different times in your post-op recovery program.

Risk of Deep Vein Thrombosis (DVT) or Blood Clots. While you're in the hospital or during your first few days at home, you will likely be not up and moving around a lot, which can put you at higher risk for developing a blood clot in your legs. The clotted blood can then move through your bloodstream to the lungs, causing a life-threatening pulmonary embolism (PE). Even when proper prevention measures are taken, it is estimated that 3 percent of orthopedic surgical patients will develop a DVT, and 1.5 percent will develop a pulmonary embolism. DVT and PE remain the most common cause for emergency hospital re-admission following joint replacement surgeries. One of the things your surgeon will do is prescribe a few weeks of a blood thinner to help reduce your body's clotting ability. You may also have a compression device on your lower legs that rhythmically inflates and deflates to help increase blood flow.


Thrombo-Embolic Deterrent (TED) Hose.

Thrombo-Embolic Deterrent (TED) hose may be prescribed by your surgeon to treat fluid retention and swelling as well as to lessen the risk for DVT in the legs. Usually they are placed on your legs in the operating room once surgery is complete. As patients lie in bed following surgery, blood is more likely to pool in the calf and create the right environment where a clot might form. TED hose work by administering pressure on the lower part of the legs and feet, with the strongest compression at the calf muscle. This compression also works to reduce fluid accumulation in your legs. Excess swelling following surgery can cause pain and result in you not being able to move your new joint with a complete range of motion.

TED hose compression levels are measured in millimeters of mercury (mmHg), just as we measure blood pressure. Compression levels for the hose are 20mmHG or below and they change as you move up the hose to facilitate optimum blood flow . Most patients wear TED hose for three weeks or less. Once you are up and about with some regularity, the risk of a clot lessens significantly and you may no longer need to wear them. While wearing TED hose, you may take them off to shower or bathe. You can wear socks, slippers or shoes over them.


Compression stockings.

Whereas TED hose are prescribed for non-ambulatory patients, compression stockings are best suited for patients who are able to move around. Generally, compression products like this are for patients with circulatory problems such as venous insufficiency, lymphedema, and varicose veins. For some, this may be a temporary condition brought on by joint replacement surgery. But these products can be worn by anyone for greater leg comfort or to help reduce swelling in the legs. They are an effective way to keep blood from pooling around your ankles, which often results in foot or leg swelling.

Compression levels are higher around the ankle of the hose and usually range from 15mmHg to 20mmHg all the way up to 60mmHg. Stockings in compression levels above 20mmHg must be prescribed by your doctor. You can find a wide variety of companies online and in pharmacies that sell compression stockings. The pressure from these stockings helps your blood vessels work better. The arteries that take oxygen-rich blood to your muscles can relax, so blood flows more freely. The veins get a boost pushing blood back to your heart. Compression stockings can keep your legs from feeling tired or achy. They can also ease swelling in your feet and ankles as well as help prevent or treat spider veins and varicose veins. They may even stop you from feeling light-headed or dizzy when you stand up.

Usually knee-high stockings are adequate to help prevent DVT. But some people prefer the feel of support with thigh-high or full panty stockings. The stockings should feel snug, but not painfully tight. It should feel like your calves are being hugged, not strangled. Proper fit is essential. It is important that thigh and knee stockings not roll down when worn, which can create pain and a lack of good circulation. If you need the stockings for medical reasons, your doctor will measure your legs and prescribe the right ones for you. If you are purchasing compression stockings yourself, make sure they are not too long or too short. Don't fold or roll the tops down as that creates too much pressure at that point and could even act as a tourniquet on your leg. Compression stockings are just like socks or hose and you can wear shoes, slippers, and even regular socks over them if you like.

These days you can even get compression stockings in wonderful colors and patterns so you can have some fun with them in addition to helping your circulatory system. People wear compression stockings for comfort, to do better in sports, and to help prevent serious medical conditions such as development of a blood clot when traveling by air. They improve blood flow and can lessen pain and swelling in your legs. If you prefer, you can also purchase a compression sleeve, which is just the tube part of a stocking without the foot.