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Compression stockings for preventing deep vein thrombosis (DVT) in airline passengers

Clarke MJ, Hopewell S, Juszczak E, Eisinga A, Kjeldstrøm M
Published Online: 
January 20, 2010

In the last few years, there has been increasing interest in whether compression stockings (sometimes called 'flight socks') reduce the risk of DVT (blood clots in the legs) and other circulatory problems in airline passengers. The stockings are worn throughout the flight and are similar to those known to be effective in patients lying in bed after an operation. By applying a gentle pressure, to the ankle in particular, compression stockings help blood to flow. Pressure combined with leg movement helps blood in superficial veins to move to the deep veins and back to the heart. The blood is then less likely to clot in the deep veins, which could be fatal if the clot moves to the lungs.

Wearing compression stockings resulted in a very large reduction in symptomless DVT among airline passengers who were allocated to wear compression stockings compared to those allocated not to wear such stockings. People who wore stockings also had much less discomfort and swelling in their legs (oedema) than those who did not wear them.

These conclusions were based on nine trials, which studied over 2800 people about half of whom were randomly assigned to wearing stockings for a flight lasting at least seven hours while the other half did not. None of the passengers developed a DVT with symptoms (slowly developing leg pain, swelling and increased temperature) and no serious events (a blood clot in their lungs (pulmonary embolus) or dying) were reported. Passengers were carefully assessed after the flight to detect any problems with the circulation of blood in their legs, even if they had not noticed any problems themselves. There was a big difference in symptomless DVT between the two groups, equivalent to a reduction in the risk from a few tens per thousand passengers to two or three per thousand. Not all the trials reported on possible problems with wearing stockings but in those that did, the researchers said that the stockings were well tolerated, without any problems.

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