Compression stockings (CS) are a standard component of recovery after major surgical procedures, including a hysterectomy. These specialized garments apply gentle pressure to the legs, supporting the circulatory system when mobility is significantly reduced. They function by improving blood flow from the lower extremities back toward the heart. Compression garments are typically introduced before or immediately after the procedure and their use continues into the recovery period.
The Role of Compression Stockings in Post-Surgical Recovery
A hysterectomy is considered a major surgery, and like other such procedures, it temporarily increases the risk of developing a Venous Thromboembolism (VTE). VTE is a serious medical condition encompassing both Deep Vein Thrombosis (DVT)—a blood clot usually in the leg—and Pulmonary Embolism (PE), which occurs if that clot travels to the lungs.
The primary reason for this heightened risk is the period of immobility experienced both during the surgery and in the immediate hours and days afterward. When the leg muscles are not active, the blood flow slows down, allowing blood to potentially pool in the deep veins, which increases the likelihood of clot formation.
Compression stockings counteract this pooling by exerting graduated pressure along the leg. The pressure is strongest at the ankle and gradually decreases further up the leg, creating a gradient that encourages the blood to flow more efficiently back toward the heart.
Recommended Duration of Use
The duration for wearing compression stockings after a hysterectomy is heavily influenced by individual factors, but general guidelines exist. Patients are typically advised to wear the stockings continuously for the first 48 hours following the operation, even while resting in bed. This initial continuous wear is a standard protocol for preventing DVT while the patient is largely confined to the hospital bed.
Following the first two days, the recommendation for most patients is to continue wearing the compression stockings day and night for at least the next two weeks. During this period, the patient should only remove them briefly for essential hygiene activities such as showering. This extended continuous use supports the circulatory system as the patient’s mobility slowly begins to increase.
The specific length of time can vary based on the type of hysterectomy performed; a less invasive laparoscopic procedure may carry a lower risk profile than an abdominal hysterectomy. Individual risk factors, such as a patient’s body mass index, personal or family history of VTE, and the overall pace of recovery, all factor into the final medical decision. Some physicians may recommend continuing daytime wear for up to four to six weeks, or until the patient has returned to her normal level of physical activity. It is necessary to follow the specific instructions provided by the surgeon or medical team.
Proper Application and Monitoring
The effectiveness of compression stockings depends directly on their correct fit and application. Stockings must be sized accurately before surgery by a healthcare professional to ensure the pressure gradient is applied correctly. A stocking that is too loose will not provide the necessary support, and one that is too tight can impede circulation.
It is recommended to put the stockings on first thing in the morning when the legs are least swollen. Using rubber gloves can help provide a better grip on the fabric, making the application process easier. Once on, ensure the stocking is pulled up smoothly, with no wrinkles or bunching, particularly around the ankle or behind the knee.
The patient must monitor the skin and toes daily for any signs of complications. Signs of improper fit or circulation issues include toes that feel cold, appear blue, or any areas of localized pain or numbness. Stockings should be washed regularly, typically by hand using a mild detergent, and air-dried to maintain their elasticity and hygiene.