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Suggest treatment for edema

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General & Family Physician
Practicing since : 2001
Answered : 8471 Questions
I have been diagnosed with dependent edema. It is expressed more in my left leg. I have a blood clot in that leg that extends from my ankle to my groin. Compression stockings have been prescribed for treatment of the condition. What type stocking would be best? How do you determine the correct size? What other treatments are available for this condition?
Posted Wed, 12 Mar 2014 in Blood Disorders
Answered by Dr. Michelle Gibson James 58 minutes later
Brief Answer: they vary according to size Detailed Answer: HI, thanks for using healthcare magic In the lower legs there are 2 sets of veins, the superficial veins that lie just under the skin and the deeper veins. The superficial veins are connected to the deep veins by valves. These valves , if they are working well ,only allow the blood to flow in one direction- from the superficial veins to the deep veins and back up to the heart. Clots in the veins in the legs damage the veins due to pressure build up. Once these valves have been damage swelling to the legs can occur , this tends to be worse once the legs are down for a prolonged time either in standing, walking or sitting with them not propped up. Treatment of this swelling can be medical or surgical. Medical is used first. Medical treatment involves the use of stockings as suggested by your doctor as well as propping your legs up at every opportunity to allow the blood to be directed back up. IN terms of stockings, when they are being used to treat the swelling associated with a clot , a pressure (the pressure the stocking can exert) is normally 30 to 40 mmHg is usually best.Normally this is written on the prescription by the doctor. If this is too tight when you try it, then your doctor would adjust it. They can be knee, thigh or full length. The knee length is the most comfortable. It may be enough if you are able to keep your legs elevated at points during the day but if not , you may need a longer one. In terms of the size, this is dependent on the size of your leg. Normally you would need to measure at the smallest part of the ankle, largest aspect of the calf and the distance from the floor to the knee crease- this is for a knee stocking. For a thigh stocking, the first 2 measurements would be needed plus the thigh diameter just about 3 inches below the gluteal crease and the distance from the floor to this point. Using these measurements you should be able to obtain stockings at your local pharmacy, they may also be available online. Your doctor may also be able to tell where they are available in your area. If medical treatment is not effective and the problem is significant then there are other options such surgical treatment or sclerotherapy (injecting a substance into the veins). I hope this helps, feel free to ask any other questions
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