Elasticized stockings, also known as compression hose, anti-embolism stockings, or TED hose, are specialized garments designed to apply graduated pressure to the legs. This pressure is strongest at the ankle and gradually decreases further up the leg, which helps push venous blood back toward the heart against gravity. The primary function of these stockings is to improve blood flow, which aids in preventing conditions like deep vein thrombosis (DVT) and managing chronic venous insufficiency or edema (swelling). Proper and consistent use, including following a specific removal schedule, is necessary to achieve the therapeutic benefit.
The Routine Daily Removal Schedule
The standard protocol for most people wearing elasticized stockings requires removal at least once every 24 hours. This applies whether the stockings are used for chronic venous insufficiency or to manage daily swelling. The common practice is to apply them in the morning when swelling is minimal and remove them before going to bed at night. This daytime-only wear pattern aligns with the body’s natural cycle, as gravity-related fluid accumulation is greatest when a person is upright.
Removing the stockings at night allows the legs to be free of compression while lying down, when venous return is naturally more efficient. Continuous wear is generally discouraged due to the risk of skin irritation and pressure damage. In specific post-operative situations, a healthcare provider may direct 24-hour wear for a limited time. This should not extend beyond a few days without strict medical supervision and frequent skin checks.
Mandatory Skin Assessment and Hygiene Breaks
Daily removal is necessary for performing essential skin assessment and hygiene. The continuous pressure exerted by the garment, particularly over bony prominences like the ankles, heels, and shins, can lead to skin irritation or breakdown if not monitored. Once the stockings are removed, the entire covered area must be carefully inspected for signs of redness, blistering, chafing, or indentation that does not fade quickly. Any red marks remaining visible 15 to 20 minutes after removal warrant a professional medical review, and the stockings should not be reapplied until the issue is resolved.
After inspection, the skin must be thoroughly washed with a mild soap and completely dried before reapplication. Trapped moisture encourages fungal infections or maceration (softening and breakdown of skin tissue). Apply prescribed emollients or moisturizers after removal at night, allowing them to fully absorb overnight. Applying creams just before donning the stockings can damage the garment’s elastic fibers.
Signs That Require Immediate Removal
Specific physical signs demand immediate, non-routine removal of the elasticized stockings, regardless of the daily schedule. These include sudden, new, or severe pain, or a significant increase in discomfort that was not previously present. The development of numbness, tingling, or a “pins and needles” sensation in the foot or toes suggests the stocking may be impeding nerve function or circulation.
Prompt removal is also necessary for visible changes in the limb’s color or temperature. If the toes turn white, blue, or purple, or feel noticeably cold, the stocking is likely too tight or incorrectly fitted and is compromising arterial blood flow. New or increased swelling appearing above the top edge of the stocking indicates the garment may be acting as a tourniquet, hindering the flow of fluid. Once removed due to any of these symptoms, the stocking should not be reapplied until a healthcare professional has assessed the limb and resolved the underlying issue.