Do anti-embolism stockings fit our legs? Leg survey and data analysis

Background
Anti-embolism stockings are commonly used worldwide to prevent the development of thrombosis in hospitalised patients. Patients are typically measured for, and fitted with, anti-embolism stockings during extended periods of non-ambulation. Anti-embolism stockings must critically fit the leg to achieve optimum blood flow and thus success of prophylaxis. Therefore, hospitals endeavour to maintain stock of anti-embolism stockings that fit the majority of their patients.

Objectives
The objective of this study was to establish whether popular styles/brands of anti-embolism stockings “fitted” the legs of randomly selected volunteers.

Design/Methods
Volunteer’s legs were measured at ankle, calf and thigh following guidance from British nurses and in accordance with brand instructions. Leg measurements were subsequently compared to the size charts of 10 anti-embolism stocking styles made by 4 different manufacturers. “Fit” is defined as a volunteer’s leg measurements matching any stocking size in a range at all measurement points.

Settings
Volunteers were measured in different settings around Scotland, including private homes, work places and shopping centres.

Participants
A convenience sample of 471 volunteers (283 female, 188 male) were recruited on the basis of willingness to participate and being over 16 years old. Volunteers ranged from 17 to 82 years old with an average age of 35.

Results
The 10 different styles of anti-embolism stockings, made by 4 different brands, examined for this paper had a “fit” coefficient ranging from 0% to 100% for our volunteer’s legs. The fit coefficient is strongly influenced by the Brand’s sizing policy.

Conclusions
The proportion of legs that “fit” a particular brand of anti-embolism stockings can be increased through: 1. the reduction of the number of leg measurement points that need to be matched to the size chart of the stockings; 2. the use of open-ended size ranges; 3. the use of increased size range width and 4. the use of increased overlap between sizes. However, all but the last of these measures can have a potentially deleterious impact on the ability of the stocking to deliver the optimum graduated pressure profile to all legs that “fit” the stocking, resulting in important implications to the efficacy of prophylaxis.