Anti-embolism stockings (AES) are specialized garments prescribed to patients who are temporarily immobile or confined to a bed. These stockings are designed with firm, elastic material that applies graduated pressure to the legs, with the highest compression at the ankle that gradually decreases up the leg. This action promotes the return of blood flow back toward the heart. The primary purpose of AES is to prevent the pooling of blood, which significantly reduces the risk of forming a deep vein thrombosis (DVT), a blood clot in the deep veins of the leg. A clot can potentially break loose and travel to the lungs, causing a pulmonary embolism (PE). The duration of wear is not a fixed schedule but is solely determined by a healthcare provider based on an individual’s specific medical situation.
Determining the Necessary Duration
The length of time a person must wear anti-embolism stockings depends directly on the underlying medical reason and the patient’s mobility status. In acute care, such as following major surgery, the stockings are generally required until the patient returns to their normal level of activity. For example, recovery from procedures like hip or knee surgery often requires wear for a few days up to six weeks.
The decision to continue wearing the stockings is tied to the risk of venous thromboembolism (VTE), which remains elevated during periods of decreased movement. After abdominal surgery, the requirement might be one to four weeks. More extensive cardiac or vascular surgeries may necessitate wear for six to twelve weeks due to slower healing and a higher clot risk. The duration is tied to a medical assessment of the patient’s ability to walk consistently, not a fixed calendar date.
Daily Protocol for Use and Care
In a hospital or acute setting, anti-embolism stockings are typically worn continuously, day and night, to provide uninterrupted prophylaxis against blood clots. The stockings must be removed at least once a day for a brief period so the patient can wash their legs and for a thorough inspection of the skin. This continuous wear must be balanced with the need for hygiene and skin assessment.
The skin should be checked daily for any signs of irritation, redness, pressure marks, or blistering, particularly over the heels and bony areas. The stockings must be reapplied smoothly, ensuring there is no bunching or wrinkling, especially behind the knee or at the ankle. Rolling the tops down is strictly advised against, as this creates a constrictive band that can impede circulation. If a patient is provided with multiple pairs, they should be laundered every two to three days to maintain elasticity and effective compression.
When and How to Safely Discontinue Use
The primary medical sign indicating that anti-embolism stockings are no longer necessary is the patient’s return to consistent, independent ambulation. Once a patient can walk normally and frequently, the active contraction of the calf muscles promotes blood flow, reducing the dependence on external compression. The decision to discontinue the use of AES must be a medical instruction from the prescribing healthcare provider.
Stopping the use of the stockings too early, while the patient is still largely immobile, carries the risk of a rebound increase in VTE formation. Discontinuation is also indicated if the patient experiences pain, discomfort, or develops skin issues such as a rash, bruising, or discoloration that suggests an allergy or improper fit. In some cases, once the acute risk period is over, a physician may recommend transitioning to a lower-level, over-the-counter graduated compression sock for ongoing support, particularly if swelling remains a concern.