It is a common misunderstanding that Thromboembolism-Deterrent (TED) hose and standard compression socks are interchangeable, simply serving the same general purpose of improving leg circulation. While both garments utilize external pressure to assist blood flow, their design, pressure profile, and intended use are distinctly different. The key distinction lies in the patient’s mobility level and the specific medical goal the garment is designed to achieve. Understanding these differences is necessary for ensuring the correct garment is used for the correct situation.
The Core Mechanism of Compression Therapy
Compression therapy operates on a simple mechanical principle: applying external elastic pressure to the limbs to support the vascular system. This pressure counteracts the effects of gravity and helps push deoxygenated blood and fluids back toward the heart. The external squeeze reduces the diameter of the major veins, which increases the speed of blood flow and reduces the chance of blood pooling, known as venous stasis.
A specialized feature in many compression garments is “graduated compression,” where the pressure is highest at the ankle and systematically decreases up the leg. This gradient mimics the natural flow of blood against gravity, actively helping to move it upward. Compression also helps the natural valves inside the veins function more efficiently by keeping the vein walls closer together, preventing the backward flow of blood.
Thromboembolism-Deterrent (TED) Stockings
TED hose are a specific type of anti-embolism stocking designed for non-ambulatory patients, such as those who are bedridden or immediately post-surgery. Their main function is prophylaxis: preventing the formation of deep vein thrombosis (DVT) in patients with severely limited mobility. Since the patient is lying down, the calf muscle pump, which normally aids circulation during walking, is inactive.
The pressure profile of TED hose is typically lower and less graduated than standard compression socks, often falling in the range of 8–18 mmHg. Because the patient is reclined, gravity is not the primary obstacle to venous return, so a lower level of compression is sufficient to maintain baseline circulation. These stockings are generally prescribed for short-term use in a hospital setting and are not intended for long-term wear once a patient regains full mobility.
Standard Graduated Compression Garments
Standard graduated compression garments, including socks and stockings, are designed for individuals who are ambulatory and mobile throughout the day. Their purpose is to manage chronic conditions, alleviate symptoms, and support circulation while the wearer is upright. They are commonly used to treat symptoms like leg swelling (edema), chronic venous insufficiency, and discomfort associated with varicose veins.
These garments feature a much wider range of compression levels, typically starting at 15–20 mmHg for over-the-counter varieties and extending up to 50 mmHg for prescription-strength products. The strong graduated pressure, highest at the ankle, is specifically engineered to counteract the full force of gravity experienced during prolonged periods of sitting or standing. Active individuals, such as athletes and frequent travelers, also use these socks to enhance performance and recovery by promoting efficient blood flow.
Key Differences in Pressure and Function
The core difference is intended use: TED hose are for non-ambulatory patients, while compression socks are for mobile individuals. This distinction dictates their pressure profiles; TED hose use lower, often more uniform compression (typically below 20 mmHg) to prevent clots in a reclined body. Standard compression socks use higher, precisely graduated compression (starting at 15–20 mmHg and increasing) to actively fight gravity in an upright body.
Sizing methods also differ significantly, reflecting their distinct applications. TED hose often use generalized sizing for hospital efficiency, whereas standard graduated compression garments require precise leg measurements to ensure the accurate pressure gradient is applied. Using TED hose for daily activity is inappropriate because their lower pressure is insufficient against gravity, and wearing high-level graduated compression when non-ambulatory can create dangerous pressure points.