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Case report
peer-reviewed

Compression Stockings and Pressure Ulcers: Case Series of a Neglected Issue



Abstract

Pressure ulcers develop in patients who endure long periods of immobilization, often caused by conditions such as musculoskeletal and neurological diseases. Pressure ulcers adversely affect the patient and increase caregiver burden and healthcare costs. Typical sites for these ulcers include the sacrum, trochanters, and heels; they also occur on the nape of the neck, penis, nostrils, helix of the ear, and upper back. Compression stockings are commonly used to prevent and stop the progression of venous disorders, including deep vein thrombosis, but their role in the development of pressure ulcers is not well known. We describe three case reports of pressure ulcer development due to prolonged application of compression stockings. In each case, the nursing staff who were primarily responsible for the prevention of pressure ulcers applied the stockings continuously without any intermittent relief. Moreover, the stockings did not include manufacturer instructions, such as recommended exposure times and applications. We recommend that nursing staff be trained in pressure relief and prevention of pressure ulcers, including rare occurrences, and that manufacturers give detailed guidance regarding the safe use of compression stockings.



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Case report
peer-reviewed

Compression Stockings and Pressure Ulcers: Case Series of a Neglected Issue


Author Information

Farooq A. Rathore Corresponding Author

Department of Rehabilitation Medicine, PNS Shifa Hospital, DHA II, Karachi 75500, Pakistan

Department of Rehabilitation Medicine, Bahria University Medical and Dental College, Bahria University, DHA -II, Karachi

Department of Rehabilitation Medicine, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada

Faria Ahmad

Department of Rehabilitation Medicine, CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan

Omer J. Khan

Dept of Rehabilitation Medicine, Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Punjab, Pakistan


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Informed consent obtained. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Acknowledgements

Authors gratefully acknowledge the critical review of the manuscript by Fiona JVW Stephenson FRCN, RN Fellow of the Royal College of Nursing SCI Nurse Specialist Co-Founder International Network of SCI Nurses Member of the ISCoS Education and Disaster Committees


Case report
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Compression Stockings and Pressure Ulcers: Case Series of a Neglected Issue


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Case report
peer-reviewed

Compression Stockings and Pressure Ulcers: Case Series of a Neglected Issue

Farooq A. Rathore">Farooq A. Rathore , Faria Ahmad">Faria Ahmad, Omer J. Khan">Omer J. Khan

  • Author Information
    Farooq A. Rathore Corresponding Author

    Department of Rehabilitation Medicine, PNS Shifa Hospital, DHA II, Karachi 75500, Pakistan

    Department of Rehabilitation Medicine, Bahria University Medical and Dental College, Bahria University, DHA -II, Karachi

    Department of Rehabilitation Medicine, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada

    Faria Ahmad

    Department of Rehabilitation Medicine, CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan

    Omer J. Khan

    Dept of Rehabilitation Medicine, Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Punjab, Pakistan


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Informed consent obtained. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements

    Authors gratefully acknowledge the critical review of the manuscript by Fiona JVW Stephenson FRCN, RN Fellow of the Royal College of Nursing SCI Nurse Specialist Co-Founder International Network of SCI Nurses Member of the ISCoS Education and Disaster Committees


    Article Information

    Published: October 10, 2017

    DOI

    10.7759/cureus.1763

    Cite this article as:

    Rathore F A, Ahmad F, Khan O J (October 10, 2017) Compression Stockings and Pressure Ulcers: Case Series of a Neglected Issue. Cureus 9(10): e1763. doi:10.7759/cureus.1763

    Publication history

    Received by Cureus: August 15, 2017
    Peer review began: September 24, 2017
    Peer review concluded: October 04, 2017
    Published: October 10, 2017

    Copyright

    © Copyright 2017
    Rathore et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Pressure ulcers develop in patients who endure long periods of immobilization, often caused by conditions such as musculoskeletal and neurological diseases. Pressure ulcers adversely affect the patient and increase caregiver burden and healthcare costs. Typical sites for these ulcers include the sacrum, trochanters, and heels; they also occur on the nape of the neck, penis, nostrils, helix of the ear, and upper back. Compression stockings are commonly used to prevent and stop the progression of venous disorders, including deep vein thrombosis, but their role in the development of pressure ulcers is not well known. We describe three case reports of pressure ulcer development due to prolonged application of compression stockings. In each case, the nursing staff who were primarily responsible for the prevention of pressure ulcers applied the stockings continuously without any intermittent relief. Moreover, the stockings did not include manufacturer instructions, such as recommended exposure times and applications. We recommend that nursing staff be trained in pressure relief and prevention of pressure ulcers, including rare occurrences, and that manufacturers give detailed guidance regarding the safe use of compression stockings.



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Farooq A. Rathore

Department of Rehabilitation Medicine, PNS Shifa Hospital, DHA II, Karachi 75500, Pakistan

For correspondence:
farooqrathore@gmail.com

Faria Ahmad

Department of Rehabilitation Medicine, CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan

Omer J. Khan

Dept of Rehabilitation Medicine, Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Punjab, Pakistan

Farooq A. Rathore

Department of Rehabilitation Medicine, PNS Shifa Hospital, DHA II, Karachi 75500, Pakistan

For correspondence:
farooqrathore@gmail.com

Faria Ahmad

Department of Rehabilitation Medicine, CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan

Omer J. Khan

Dept of Rehabilitation Medicine, Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Punjab, Pakistan