Compression stockings are specialized elastic garments that apply graduated pressure to the lower legs, strongest at the ankle and gradually decreasing upward. After hip replacement, the primary purpose of wearing them is to promote healthy blood circulation and prevent deep vein thrombosis (DVT). Following the guidance of a healthcare provider regarding their use is important for a safe recovery.
Understanding Hip Precautions Before Application
After hip replacement surgery, hip precautions are enforced to prevent the new joint from dislocating. These restrictions influence how a person safely performs activities like putting on a stocking. Patients must avoid bending the operated hip past a 90-degree angle, as this deep flexion puts excessive stress on the joint.
The leg must not rotate internally; keep the toes and kneecap pointing forward and avoid inward twisting. Crossing the legs at the knees or ankles must also be avoided, as this movement compromises the stability of the new hip. These precautions are maintained for several weeks post-surgery to allow soft tissues to heal securely.
Step-by-Step Guide for Safe Stocking Application
Before application, the patient should be in a safe, seated position, such as on the edge of a bed or a firm chair with arms. Ensure the hip is higher than the knee to prevent excessive bending, keeping the leg slightly out in front to maintain a safe hip angle. Using a plastic bag or cornstarch on the foot can reduce friction, helping the tight material slide more easily.
Gather the stocking material completely down to the heel pocket before placing it over the foot. Insert the foot into the gathered material, pulling the stocking over the heel until the heel cup is properly seated without wrinkles. A long-handled reacher or dressing stick assists in maneuvering the stocking over the foot without bending beyond the 90-degree limit.
Smooth the rest of the material up the calf slowly and evenly, using the reacher or hands while keeping the torso upright. The stocking must be pulled up so the graduated compression is distributed correctly and the material remains completely smooth. Any wrinkles or bunching create concentrated pressure points that impede circulation.
Specialized Tools for Easier Dressing
To apply a compression stocking while adhering to hip precautions, specialized adaptive equipment is recommended. The most common tool is a stocking donner, also known as a sock aid, which is a rigid or flexible device designed to hold the stocking open. This tool allows the patient to pre-load the stocking onto a frame, often a U-shaped piece of plastic, and then use long straps to lower the entire assembly to the floor.
The foot slides into the opening, and the straps pull the stocking up the leg, fully eliminating the need to bend over. These aids allow the patient to maintain the necessary safe hip angle, promoting greater independence in dressing. Long-handled reachers are also used with the stocking donner to retrieve the tool or adjust the stocking higher up the leg without straining the hip. Choosing a donner designed for the tighter compression material, rather than a generic sock aid, simplifies the process.
Monitoring Skin and Circulation
After the compression stocking is applied, check the foot and lower leg for signs of adequate circulation. The toes should remain their normal color, and the skin should feel warm to the touch. Discoloration, coldness, or a tingling sensation indicates the stocking is too tight or incorrectly placed.
Patients should also check for swelling above the top edge of the stocking, which suggests the garment is restricting blood flow. The skin underneath should be monitored daily for irritation, redness, or pressure sores caused by bunched or wrinkled fabric. Stockings are removed daily, and a long-handled reacher can assist with safe removal. Report any persistent discomfort or changes in skin color and sensation promptly to a healthcare provider.