Anti-Embolism Stockings vs Compression Stockings – Which One?

In the nursing world, it is not unheard of for people to interchange anti-embolism stockings and compression stockings. When working in the hospital as a nurse or a nursing student, it is important to know that each of these stockings is different and serves different purposes. Although both are compression stockings, you can only achieve optimal results when the right one is used at the appropriate time.

What Are Anti-embolism Stockings?

Anti-embolism stockings or thrombo-embolic deterrent (T.E.D.) hose are either knee or thigh-length stockings made from elastic.

 Knee-length anti-embolism stockings
Knee-length anti-embolism stockings

The pressure is applied on the superficial veins when the stockings compress the legs in order to reduce or prevent formation of blood clots. This leads to increase in blood flow and makes sure the veins in the legs do not expand.

In addition, anti-embolism stockings help in preventing the adverse effects of venous distension during surgery. One can feel the compression of TED hoses mainly in the ankle area. The pressure pattern is graduated and applied at the ankle, calf, popliteal, lower thigh, and upper thigh. Before using these stockings, the patient’s legs should be measured to ensure that the pressure pattern is appropriately applied. The pressure applied mainly helps to make sure blood does not pool in both legs.

Thigh-length Anti-embolism Socks
Thigh-length Anti-embolism Socks

These white stockings are mainly appropriate for patients who are either confined to a bed or just non-mobile. The stockings are ineffective for individuals who are sitting, walking, and standing. They are affordable and offer temporary solutions to post-surgery patients and patients in nursing homes. TED hoses should be replaced with a new pair after about three weeks. Since the stockings are not designed for mobile use, nurses should not wear them.

Who Uses Anti-embolism Stockings?

Surgical patients that have high risk of venous thromboembolism (VTE) should use anti-embolism stockings to prevent death and morbidity.

Medical Conditions that Require the Use of Anti-embolism Stockings

Some of the medical conditions that may require a patient to use anti-embolism stockings include:

  • Patients at high risk of having VTE, like those with active cancer, reduced mobility, and history of VTE.
  • Patients who have impaired mobility (bed bound, chair-bound, or unable to walk without aid) even after being discharged from the hospital can use TED hose until they can walk unaided.
VTE Patient with Anti-embolism Stockings
VTE Patient with Anti-embolism Stockings

How to Wear Anti-embolism Stockings

Firstly, you have to measure the patient’s legs in order to get the correct size. To measure, the patient can be in bed or in a standing position. Note that each leg may have different measurements.

Before putting on the stockings, lie down and prop up your legs on top of pillows. Leave the legs on the pillows for about 15 minutes.

To make it easier to wear the stockings, put some powder on each ankle. Your healthcare provider will advise you on the type of powder you should use.

Gently pull the stocking on your foot. With short but quick moves, pull the loose material of the stockings gathered onto your leg. Make sure they stay smooth and do not wrinkle at any point.

What Are Compression Stockings?

Thigh-length Compression Stockings
Thigh-length Compression Stockings

Compression stockings are a hosiery made with elastic material and worn on legs to compress the limb. They are tight-fitting, stretchy, and look more like a panty hose. The elastics used are strong to increase pressure on the lower extremities like the feet, ankles, and legs. They are tightest around the ankles, but the constrictiveness reduces towards the knees and the thighs.

Compression Stockings for Who?

Compression stockings are for people who can walk but are at risk of suffering leg fatigue, lymphedema (leg swelling), varicose veins, etc.

Function of Compression Stockings

The main function of compression stockings is to help reduce the diameter of the distended veins in the legs and also increase the velocity of venous blood flow. By so doing, the valve becomes more effective. When the surface veins, as well as the arteries and the muscles are compressed, blood will be forced to pass through channels that are narrower. This increases pressure on the arteries, which increase the blood that returns to the heart, and reduces the blood that pools in the feet.

Varicose Veins Vs. Healthy Veins
Varicose Veins Vs. Healthy Veins

Benefits of Using Compression Socks

There are many benefits of using compression stockings, and one of them is boosting the veins so they can easily push blood to the heart. This helps to improve the way blood vessels work by relaxing the arteries.

Additionally, they prevent your legs from getting achy and prevent swelling in the ankles and feet. You can use compression stockings if you usually feel dizzy whenever you stand up. People whose job requires them to be on their feet a lot will need these stockings.

Deep Vein Thrombosis
Deep Vein Thrombosis

When to Use Compression Stockings

Those who need compression stockings include:

  • People who just had a surgery
  • Athletes
  • Pilots, and people who spend a lot of time on airplanes
  • Pregnant women
  • People who find it hard to move their legs or who cannot leave their bed
  • People whose work requires that they stand all day

Medical Conditions that Require the Use of Compression Stockings

Some of the medical conditions that will require a person to use compression stockings include:

  • Chronic peripheral venous insufficiency: This condition occurs when the veins can no longer pump deoxygenated blood to the heart.
  • Deep vein thrombosis: This condition occurs when blood flow in the lower extremities decreases, causing blood pooling in the legs and consequently resulting in the formation of blood clot.
  • Edema: This condition occurs when opposing forces in small blood vessels as well as capillaries cause the plasma water to enter the soft tissues in a process known as net ultra-filtration.
  • Lipodermatosclerosis: This refers to a subcutaneous fat that is inflamed, and is one of the ways panniculitis forms.
  • Lymphedema: This medical condition has to do with the swelling of a body part when lymph fluid accumulates abnormally. It usually happens whenever something interferes with the process of lymph fluid drainage into the blood. Consequently, this could make the arm, neck, leg, or abdomen to swell.
  • Phlebitis: This occurs when the vein is inflamed and has blood clots in it caused by trauma, infection, or inflammation. It is predominantly found in leg veins and mostly affects people with varicose veins. Due to the sudden occurrence of inflammation, the thrombus firmly adheres to the wall of the vein and puts the superficial vein at risk of clogging.
  • Varicose veins: These veins are saccular and distended with tendency to expand and lead to venous inflammation. When they develop, they can be very painful and do not disappear without treatment. When varicose veins form externally, it is a sign that the patient has venous weakness

How to Wear Compression Stockings

How to Wear Compression Stockings
How to Wear Compression Stockings

First, smooth the stockings out until they lay flat against your legs without bunching.

They should not be too long and you should not roll down the tops to avoid making them too tight. When the stockings get too tight, it can cut off blood circulation and cause other issues relating to blood flow.

If they were prescribed by a doctor, you should endeavor to wear them almost all day. However, you can take the compression stockings off when you want to bathe. It is possible to wear your socks, shoes, or slippers over them and go about your normal duties.

Compression Stockings Worn with Footwear and Jewelry
Compression Stockings Worn with Footwear and Jewelry

Anti-embolism Stockings vs. Compression Stockings

Quite often, patients are given the wrong stockings for their condition because most people do not really understand the difference between the two. The differences are mainly seen in their design, use, and duration. Here are some of the major differences:

Purpose:

Having established that both stockings are used for compression, it is important to note that they differ in purpose. The medical reason behind wearing any of them is a major way to differentiate anti-embolism stockings from compression stockings.

Anti-embolism socks

When blood clots, it could result in medical complications. TED hose is worn to prevent blood pooling in some parts of the limb and reduce risk of blood clotting, known as embolism. Hence, anti-embolism stockings are best suited for post-operative patients or patients who are not mobile.

Compression Socks

In contrast, the purpose of wearing compression stockings is extreme improvement of blood flow by squeezing gently. They come in handy when a person is suffering from a condition that needs a more aggressive kind of compression. These stockings are mainly designed to meet the needs of ambulatory or mobile patients. Compression stockings are highly recommended by physicians for treating conditions like edema, chronic venous insufficiency, varicose veins, deep vein thrombosis, lymphedema, phlebitis, lipodermatosclerosis, and even pregnancy.

Design

Compression Stockings in Different Styles and Colors
Compression Stockings in Different Styles and Colors

TED hose and compression stockings are designed differently in order to function optimally. In terms of appearance, anti-embolism stockings are only found in white color with a hole around the toes for monitoring the circulatory status of the patient. Compression stockings on the other hand come in different styles and colors.

Compression Levels

Graduated Compression Levels
Graduated Compression Levels

One major difference between anti-embolism stockings and compression stockings is that they vary in compression levels. Both stockings have their compression levels measured in millimeters of Mercury (mmHg). Unlike anti-embolism stockings, compression stockings offer graduated compression. This means that the stockings are very tight around the ankle, but ease gradually upwards.

Most anti-embolism stockings have a compression level of 8 to 18mmHg, while compression stockings are mainly classified into three compression levels: 30 to 40mmHg, 20 to 30mmHg, and 15 to 20mmHg. This means that the compression level of anti-embolism stockings is lower than that of compression stockings. It is important that patients who need compression levels that exceed 20mmHg get a doctor’s prescription first.

Duration

The duration of use of both stockings depends on the case of the individual. However, the length of use of anti-embolism stockings is short-term, while compression stockings have long-term use.

Anti-embolism stockings will have to be replaced with a new pair after about three weeks, while you can use compression stockings for about 6 months before needing a new pair or as recommended by a doctor.

Final Thought

It is important to give your legs the right support when they can no longer offer you a lot of support. Medical personnels, patients, and caregivers need to be aware of the differences between anti-embolism stockings and compression stockings. An in-depth understanding of the patient’s condition is also required before choosing the most suitable compression garments.

Conclusively, individuals should be assessed by health professionals, have their legs measured, and closely monitored while using the stockings.