The Effect of Training and Use of Graduated Compression Stockings in Surgery Patients

محورهای موضوعی : Report of Health Care

Arzu ŞEN ¹ (Institute of Health Sciences, Zonguldak Bulent Ecevit University,Zonguldak, Turkey)
Elif KARAHAN ² (Department of Nursing, Faculty of Health Sciences, Zonguldak Bulent Ecevit University, Zonguldak, Turkey)

تاریخ دریافت : 1398/01/26 تاریخ پذیرش : 1398/10/01 تاریخ انتشار : 1398/09/10

کلید واژه: Venous Thrombosis, Stockings, Patient Education, Nursing Care,

چکیده مقاله :

Introduction: The risk of developing deep vein thrombosis is very high among the surgery patients if appropriate precautions are not taken. Graduated compression stockings, that are used to prevent deep vein thombosis, may threaten patient’s safety if they are not used properly. This study was carried out to examine the use of graduated compression stockings in surgery patients and the effect of training given about deep vein thrombosis in a cross sectional and semi-experimental design. Methods: The study was conducted in General Surgery, Brain Surgery and Urology Clinics of a Healthcare Practice and Research Center located in the western Black Sea region between February 2017 and February 2018. Sample of the study was composed of a total of 166 patients who were assigned to both groups randomly. Patients in Group I were given training about deep vein thrombosis during preoperative period; and patients included in Group II were provided routine nursing care in the clinics. The use of graduated compression stockings by the patients and the problems they experienced were evaluated within the first 48 hours following surgery. Descriptive tests, the Kolmogorov Smirnov test, Independent-samples t test, Mann Whitney U test, Pearson, Yates and Fisher exact chi-square tests and McNemar test were used for statistical analyses. Results: The risk of deep vein thrombosis was found to be comparable between both patient groups during preoperative assessment. It was determined that all of the patients who were given training about deep vein thrombosis used graduated compression stockings, and 33.7% of the patients who got routine care did not know how to use them. The problems of itching (p=0.729) and sweating (p=0.225) were found to be experienced by both goups. It was also observed that graduated compression stockings slided downwards (p=0.001) and redness (p=0.001) occurred in the patients group who got routine care. Conclusion: The training provided by the nurses had a positive effect on the adjustment to the use of graduated compression stockings among the patients who underwent surgical intervention. Providing training to the patients is suggested to be crucial in order to provide an efficient and reliable care to the surgery patients who are under risk for deep vein thrombosis, and it is important not to neglect it.

منابع و مأخذ:

1. Hill J, Treasure T. Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in inpatients having surgery: summary of NICE guidance. BMJ. 2007; 334 (7602): 1053- 1054.


2. Association of perioperative Registered Nurses. AORN guideline for prevention of venous stasis. AORN J. 2007; 85 (3): 607- 624.


3. Moheimani F, Jackson DE. Venous thromboembolism: classification, risk factors, diagnosis, and management. ISRN Hematol. 2011; 2011: 124610.


4. Edmonds MJR, Crichton TJH, Runciman WB. Evidence-based risk factors for postoperative deep veinthrombosis. ANZ J Surg. 2004; 74: 1082- 1097.


5. Geerts WH, Bergqvist D, Pineo GF. American college of chest physicians evidence- based clinical practice guidelines prevention of venous thromboembolism. Chest J. 2008; 133 (6): 381- 453.


6. Long JB. Venous thromboembolism: pharmacological and nonpharmacological interventions. J Cardiovasc Nurs. 2009; 24 (6): S8- 13.


7. Autar R. A review of the evidence for the eficacy of antiembolismstockings (AES) in venousthromboembolism (VTE) prevention. J Orthopaedic Nurs. 2009; 13 (1): 41- 49.


8. Walker L, Lamont S. Graduated compression stockings to prevent deep vein thrombosis. Nurs Stan. 2008; 22 (40): 35- 38.


9. Winslow EH, Debra L, Brosz DL. Graduated compression stockings in hospitalized postoperative patients: Correctness of usage and size. AJN. 2008; 108 (9): 40- 50.


10. Lim CS, Davies AH. Graduated compression stockings. CMAJ. 2014; 186 (10): E391- 398.


11. Munoz-Figueroa GP, Ojo O. Venous thromboembolism: Use of graduated compression stockings. British J Nurs. 2015; 24 (13): 680- 685.


12. Öztürk H, Çilingir D, Hindistan S. Assessing through the patients of patient trainings that presented by nurses in medical and surgical clinics. DEUHYO ED. 2011; 4 (4): 153- 158.


13. Le Sage S, McGee M, Emed JD. Knowledge of venous thromboembolism (VTE) prevention among hospitalized patients. J Vasc Nurs. 2008; 26 (4): 109- 117.


14. Segal JB, Streiff MB, Hofmann LV, Thornton K, Bass EB. Management of venousthromboembolism: a systematic review for a practice guideline. Ann Intern Med. 2007; 146: 211- 222.


15. Zhao W, McArthur A, Yu Z, Hu Y, Luo J. Prevention of venous thromboembolism in postoperative abdominal patients: a best practice implementation project. JBI Database System Rev Implement Rep. 2018;16 (9): 1887- 1901.


16. Milinis K, Shalhoub J, Coupland AP, Salciccioli JD, Thapar A, Davies AH. The effectiveness of graduated compression stockings for prevention of venous thromboembolism in orthopedic and abdominal surgery patients requiring extended pharmacologic thromboprophylaxis. J Vasc Surg Venous Lymphat Disord. 2018; 6 (6): 766- 777.


17. The Joanna Briggs Institute. Best practice evidence based information sheets for health professionals. Graduated compression stockings for the prevention of post-operative venous thromboembolism. Best Practice. 2008; 12 (4): 1329- 1974.


18. Özkan ZK, Fındık ÜY, Ünver S. Evaluation of using compression stocking in postoperative patients. Florence Nightingale J. 2016; 24 (1): 30- 37.


19. Wade R, Paton F, Woolacott N. Systematic review of patient preference and adherence to the correct use of graduated compression stockings to prevent deep vein thrombosis in surgical patients. J Adv Nurs. 2017; 73 (2): 336- 348.


20. Byrne B. Deep vein thrombosis prophylaxis: The effectiveness and implications of using below knee or thigh-length graduated compression stockings. Heart Lung. 2001; 30 (4): 277- 284.


21. Kuroiwa M, Takahira N, Ujihashi Y, Miida K, Arai Y, Kawatani H. Reduction in the soles of graduated compression stockings prevents falls without reducing the  preventive effect for venous stasis. Thromb Res. 2015; 135 (5): 877- 881.


22. Hobson DB, Chang TY, Aboagye JK, Lau BD, Shihab HM, Fisher B, et al. Prevalence of graduated compression stocking-associated pressure injuries in surgical intensive care units. J Crit Care. 2017; 40: 1- 6.


23. Brady D, Raingruber B, Peterson J, Varnau W, Denman J, Resuello R, et al. The use of knee-length versus thighlength compression stockings and sequential compression devices. Critical Care Nurs. 2007; 30 (3): 255- 262.


24. Yılmaz S, Yaylacı S, Diken Aİ, Yalçınkaya A, Aksoy E. Compression stockings and the factors that affect their use in lower extremity venous insufficiency treatment. Turkish J Vascular Surgery. 2015; 1: 47- 53.


25. Sachdeva A, Dalton M, Lees T. Graduated compression stockings for prevention of deep vein thrombosis. Cochrane Database Syst Rev. 2018; 11: CD001484. 


26. Steel S, Peacock R. Using critically appraised topics to inform nursing practice in DVT prevention using graduated compression stockings. J Orthopaedic Nurs. 2005; 9: 211- 217.


27. Xu Y, Wang W, Zhao J, Wang J, Zhao T. Knowledge, attitude, and practice of healthcare professionals toward clinically applying graduated compression stockings: results of a Chinese web-based survey. J Thromb Thrombolysis. 2019; 47 (1): 102- 108.