Objective: To use a single fibre laser Doppler fluxmeter to assess the
microcirculatory effects of compression stockings. Design: Controlled
study comprising patient and control groups. Setting: Department of S
urgery, University College London Medical School, London, UK. Patients
and participants: Ten patients with lipodermatosclerosis caused by ch
ronic venous insufficiency and 10 control subjects. Interventions: Mea
surements were made from the liposclerotic skin of patients and 8 cm a
bove the medial malleolus in controls. Laser Doppler flux (LDF), blood
cell velocity (BCV) and concentration of moving blood cells (CMBC) we
re recorded with the subject lying supine. A class II graduated compre
ssion stocking was applied to the leg and laser Doppler recordings wer
e repeated. The protocol was repeated with the subject sitting. Main o
utcome measures: The effects of a compression stocking on LDF, BCV and
CMBC in the horizontal and sitting positions were measured. Results:
In patients in the supine position, the compression stocking resulted
in a 28% median increase in LDF (p = 0.03), with a corresponding 29% m
edian increase in BCV. There was no significant change in CMBC. In the
sitting position, the compression stocking caused a 105% median incre
ase in LDF (p<0.01) due to a corresponding 89% median increase in BCV
(p = 0.01); there was only 25% median increase in CMBC. The effects of
compression in controls were similar to those in patients. Conclusion
: Compression stockings may be effective in the treatment of chronic v
enous insufficiency by increasing the microcirculatory flow velocity.