Glossary from A-Z
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Angiology: specialty in internal medicine concerning vascular diseases.
A medical anti-embolism stocking acts by accelerating venous return in patients who are lying down; thus anti-embolism stockings help prevent thrombosis.
preoperative, intraoperative and postoperative thrombosis prophylaxis [prevention], peri- and postpartum thrombosis prophylaxis, thrombosis prophylaxis in bed-ridden patients.
Artery: blood vessel leading away from the heart that supplies the tissues.
Bandaging: dressing with textile bandages (in contrast to adhesive plaster and triangular bandages); applied in successive turns (circular, figure-of-eight or spiral). Because of the differences in their stretching properties, we differentiate between short-, medium- and long-stretch bandages.
Blood circulation: -> Wikipedia
Calf muscle pump: exerts pressure on the veins lying deep in the muscles, squeezing them to accelerate the flow of used blood back to the heart (against gravity in the legs). The calf muscle pump is activated every time a leg is moved. This is why plenty of exercise is important for the prevention and treatment of venous disorders.
Care symbols: ->GINETEX
CEAP classification: more recent classification of the severity of chronic venous insufficiency (CVI). The term is American and is the abbreviation for (C = clinical condition), (E = etiology), (A = anatomic location) (P = pathophysiology).
- C 0 No visible signs of venous disease
- C 1 Spider veins, telangiectasia or reticular veins
- C 2 Varicose veins without clinical signs of CVI
- C 3 Varicose veins with oedema
- C 4 Varicose veins with trophic skin changes
- C 4a Varicose veins with pigmentation or eczema
- C 4b Varicose veins with dermatoliposclerosis or atrophie blanche
- C 5 Varicose veins with healed ulceration
- C 6 Varicose veins with active ulceration
Chronic venous insufficiency (CVI): late complication of chronic venous disorders due to increased pressure in the veins. The resulting microcirculation disturbance in the lower limb leads to pathological changes in the veins and the skin. Clinical classification according to Widmer und Marshall:
Grade 1 varicose veins; no (notable) symptoms; no complications.
Grade 2 varicose veins; symptoms (paraesthesia, itching, heaviness, feeling of tautness, mild swelling tendency, leg cramps, pain, etc.); no complications.
Grade 3 varicose veins; symptoms (as in grade 2, but more pronounced); complications: trophic skin disorders (induration, pigmentation, dermatitis, eczema, atrophy); varicophlebitis.
Grade 4 varicose veins; symptoms (as in grade 3); complications (as in grade 3, but more pronounced); florid crural ulcer.
Compliance: patient acceptance of therapy (complies with the instructions).
Compression: (from Latin: comprimere = to press together)
Compression classes: we distinguish between four different classes of compression:
Mild compression. 18 mmHg (24 hPa) to 21 mmHg (28 hPa) at the ankle. For a feeling of tired and heavy legs, for early venous insufficiency (weakness), for mild varicose veins without pronounced oedema, for varicose veins in pregnancy, for so called “spider veins”, and after sclerosis of varicose veins.
Moderate compression. About 23 mmHg (31 hPa) to 32 mmHg (43 hPa) at the ankle. For more serious symptoms, for more marked varicose veins or moderate oedema, after resolution of minor ulcers, after sclerosis and surgery for varicose veins, after deep vein thrombosis and in cases of insufficiency (weakness) of the valves in the deep veins.
Powerful compression. About 34 mmHg (45 hPa) to 46 mmHg (61 hPa) at the ankle. For chronic venous insufficiency (weakness), pronounced oedema, atrophie blanche, dermatosclerosis and after resolution of serious ulcers.
Very powerful compression. Over 49 mmHg (65 hPa) at the ankle. For lymphoedema and disfiguring swelling.
Compression stockings are specialised stockings that are worn to prevent poor blood circulation in the legs. They prevent the pooling of blood in the veins and reduce the risk of deep vein thrombosis in the legs.
Compression therapy: is one of the most important methods in the treatment of venous disorders. Applying compression bandages or wearing compression stockings presses the distended veins (varicose veins, varicosities) together from the outside. This enables the venous valves to close again, the leg muscles can squeeze the blood better out of the veins which, in turn, improves the return transport of blood to the heart. Since veins that have once been distended are no longer able to actively contract, such compression must be used for the rest of the patient’s life if surgery is contraindicated. However, even in cases where surgery is indicated, compression stockings must also be worn or the legs must be dressed with compressive bandages for a number of weeks after the surgical removal of the veins.
Cotton -> Wikipedia
Crossectomy and vein stripping: an incision in the groin or pit of the knee. The opening in the deep saphenous vein is cleanly exposed, tied off and separated. It is important that all tributaries are divided so that no new varicose veins can arise from this region. Crossectomy ensures that the blood can no longer pool back from the deep vein into the superficial venous trunk, thus preventing reflux. After the veins have been successfully separated at the saphenous junction, stripping is performed to remove the diseased saphenous vein, which can be performed by a number of means. Only the diseased sections are stripped. The healthy venous sections must be retained and may be used later for bypass surgery.
Denier: unit for the fineness of yarns -> Fineness
Dermatology: medical specialty, science and study of skin diseases, practiced by dermatologists.
Distal: further from the centre of the body; in the context of blood vessels further from the heart (and the body).
Donning aids: device for easier donning of compression stockings.
Doppler ultrasound: diagnostic method in which ultrasound waves are used to assess the blood flow through the blood vessels.
Drainage: draining of pathological or increased volumes of natural body fluids (and gases) with the aid of a drain.
Dtex: stands for decitex. Tex is the international unit for the fineness of textile fibres, and expresses the weight in grams per 1,000m length; i.e. 1 tex is 1g/km. Decitex or dtex stands for the weight in grams of a fibre 10,000 m long. The higher the dtex figure, the coarser the fibre.
Elastane: (also: elasthane) or spandex is a synthetic fibre that can be stretched by between 500 and 800 %. It is stronger and considerably more robust than fibres made of rubber or natural caoutchouc, the primary plant-based “alternative” material. In chemical terms, elastane is a long-chain polymer containing at least 85 % polyurethane. Tradename: Lycra®
Elasticity: is the ability of a material to return to its original dimensions after application of a force -> Elastane, Elastodien
Elastodien: is a natural rubber = caoutchouc. This means “Weeping tree” in the language of the Peruvian Indians, scientifically translated it means: ”polymer with rubber-elastic properties”. Natural caoutchouc is produced from latex, the milky sap of various tropical plants. It is characterised by its extreme elasticity, tensile strength and flexibility when cold – a truly miraculous material. Despite many attempts, it has not yet been possible to replicate these properties synthetically. However, it must be said, that caoutchouc is not resistant to lipids and many other chemical substances, and disintegrates at high temperatures.
Elephantiasis: is an enlargement of a part of the body, above all the lower limbs and external genitalia, but also the breasts, caused by chronic lymphatic congestion (lymphoedema).
Embolism: partial or complete occlusion of a blood vessel by material transported in the blood vessels (e.g. blood clot). The most common form is thromboembolism.
Fineness (of yarns): the yarn fineness, yarn diameter, or the titre of a yarn, a fibre or a filament is expressed as the mass per unit length. The yarn fineness gives no indication of the strength or the volume of a yarn. A high yarn fineness has a lower ratio of mass to length, a high titre has a higher ratio.The yarn fineness is measured internationally in tex units. This unit has replaced the previous units denier (den), metric number (Nm) and English number (Ne).
1 tex: 1 gram per 1,000 m
1 dtex: 1 gram per 10, 000 m (decitex)
1 den: 1 gram per 9,000 m
Flat-knitting technique: (in contrast to round-knitting technique). Stockings with seams. The advantage of the flat-knitting technique is that the width (size) of the knitted stocking is almost infinitely variable thus enabling hosiery to be provided even for extreme physical dimensions. -> Wikipedia
HOSY: computer-controlled measuring apparatus developed by the Hohensteiner Institutes for checking the compressive properties. This system enables the compression behaviour of all types and sizes of compression stockings (including made-to-measure garments) to be accurately measured and recorded along the whole length of the stocking in one step without destroying the garment in the process. In addition to the institutes entrusted with quality assurance, the majority of the quality seal association members have access to these universal measuring machines for their development and production control.
Interstice: is the anatomical name for the spaces between organs or parts of organs -> see lymphoedema
Knit: stockings are knitted. We distinguish between round-knitted (seamless) and flat-knitted (seamed) stockings -> Wikipedia
Knitting machine: -> Wikipedia
P is the pressure
T is the tension
R is the radius
∝ is proportional
The applied pressure is directly proportional to the tension in a bandage (or compression stocking), but inversely proportional to the radius of the curve of the limbs to which the bandaging is applied (P increases with T, but P decreases with increasing R).
Leg ulcer: (Ulcus Cruris Venosum) venous ulcers in the calf are the most serious complication of chronic venous insufficiency.
LRR: light reflection rheography (LRR) is a measuring technique that uses an infra-red light source to test venous function. The result enables to the doctor to identify disturbed venous flow, carry out further examinations for the differential diagnosis, and initiate therapy if necessary.
Lycra: is the trade name for polyurethane from Invista, see elastane.
Lymph node: -> Wikipedia
Lymphatic system: -> Wikipedia
Lymphoedema: denotes the accumulation of fluid in the interstice caused by a mechanical insufficiency of the lymphatic system. Lymphoedema is a chronic inflammatory clinical picture which affects not only the extremities, but may also involve the face, neck, torso and the genitals. Due to the mechanical insufficiency, the interstitial fluid can no longer adequately flow from the tissues through the lymphatic vessels for return transport in the lymphatic system. This leads to pooling and accumulation of fluid in the intercellular spaces (oedema).
Made-to-measure stocking: made-to-measure compression stockings are produced individually for patients with disproportionate body measurements.
Microfibres: is a collective term for fibres whose individual filaments are finer than one denier. Here are a couple of comparisons to give you an idea: microfibres have half the diameter of silk fibres, one third that of cotton fibres, one quarter that of fine wool fibres, and only one hundredth of the diameter of a human hair. Example: Tactel®.
mm Hg: see Pressure
Nylon: name of a synthetic fibre (polyamide) -> Wikipedia
Oedema: previously “dropsy”, describes the accumulation of fluid from the vascular system in the tissues. If the balance between filtration on the one hand and reabsorption plus lymphatic drainage on the other hand, shifts in favour of filtration, more fluid remains in the tissues. The result is the accumulation of fluid in the interstice: oedema. Oedema usually develops as a result of an underlying disease, i.e. heart or kidney failure. The associated disorder of the circulatory system results in a pooling of blood in the vascular system with increased pressure, which forces fluid out of the vessels into the tissues. Oedema often occurs as a secondary complication of deep vein thrombosis, which impedes the return flow of blood back to the heart. The swelling that develops as a result of this is usually treated with compression stockings.
Perforating veins: form the connecting system between the superficial and the deep venous systems.
Phlebectomy: during phlebectomy, the medium-sized to large varicose veins lying just below the skin, are surgically removed. A surgical instrument fitted with a hook is introduced through small skin incisions, and the veins are removed in sections. The procedure is often repeated 10 to 20 times for each leg until all the visible varicose veins have been removed. Phlebectomy is either performed alone or at the same time as treatment of the saphenous vein(s).
Phlebitis: an inflammation of a venous vessel. Causes: poor diet, bacterial infection after an i.v. injection or infusion.
Phlebography: is an X-ray procedure for investigating the veins: in order to identify the shape and course of the veins, they are injected with a contrast medium. The X-ray is called a phlebogram and it shows the veins full of contrast medium clearly visible as “shadows” against the tissues and other structures.
Phlebology: is a medical specialty; it is concerned with the recognition and treatment of vascular diseases such as venous disorders, varicose veins (also called varices) and haemorrhoids.
Polyamide: name of a synthetic fibre (e.g. Nylon) -> Wikipedia
Polyurethane: -> Elastane
Pregnancy: is a risk factor for the onset of venous disorders in women. Women who already have had a venous disorder before pregnancy, should inform their doctor so that measures to prevent a deterioration of the venous disorder can be taken in good time.
Pressure gradient: medical compression stockings must match the physiological conditions in terms of the decrease in pressure (= gradient) from the ankle up to the higher measuring points.
Pressure: is expressed for compression stockings as mmHg (= mm mercury) or hPa (hectopascal). Pa = SI unit of pressure, 1 mmHg = 133322 Pa). The pressure that a stocking exerts on the leg can only be determined by effective pressure measurements (e.g. HOSY, MST, etc.). There is no mathematical connection with denier.
Pulmonary embolism: (almost always a pulmonary artery embolism), is caused by a blockage of a blood vessel by a blood clot, the so-called thrombus, or by gas bubbles, for instance after a diving accident. The clot that triggers the pulmonary embolism often develops in the deep veins of the leg or the pelvis and is swept through the heart into the lung. The severity of the embolism depends on the size of the clot; a small embolism is not as serious as a large one. An embolism can occur in any organ and is thus named according to the organ in which it is found.
Quality seal (RAL): in order to guarantee the medical efficacy and the high quality of compression stockings, the German Institut für Gütesicherung und Kennzeichnung e.V. (St. Augustin) [Institute for Quality Assurance and Certification] laid down the requirements for their manufacture in a recognition procedure in co-operation with manufacturers, suppliers and authorities. Compression stockings that are manufactured in compliance with these stringent requirements are awarded the RAL quality seal. Compliance with these criteria is regularly monitored.
Resting pressure: is the pressure exerted by a compression stocking or a bandage when the muscles are resting.
Round-knitting technique: (in contrast to flat-knitting technique) used for seamless stockings -> Wikipedia
Rubber stockings: obsolete name for compression stockings. Should no longer be used because most products no longer have a rubber yarn ( = elastodien).
Rubber: collective term for elastomers. See also-> Elastane -> Elastodien
Saphenous varicosis: disease of the large veins that run 1) along the front of the leg from the ankle to the groin (large saphenous vein) and 2) the back of the lower leg (small saphenous vein). This is the most common cause of venous oedema and various types of secondary disorders; in advanced stages, possibly leads to eczema or other skin changes, and crural ulcers.
Sclerosis/Sclerotherapy: form of treatment in which a substance is injected into the pathologically distended venous segment. This leads to local blood clotting which occludes the distended vein, thus “shutting it down”.
Spider veins: the smallest cutaneous blood vessels which shimmer bluish/reddish through the skin and are often a cosmetic problem. Even if spider veins are not an illness in their own right, they are often a sign of venous insufficiency. Therefore, before treating spider veins, it is always necessary to carry out a phlebological examination involving microsclerotherapy, laser therapy or a combination of the two.
Stiffness: ”stiffness” is understood as the increase in pressure underneath a compression stocking in relation to the increase in circumference of the segment of the leg due to muscular contraction when standing and walking. Materials with high stiffness apply a stronger massage effect and can more effectively prevent swelling of the legs.
Different degrees of stretch
- Long stretch: very elastic support stockings (e.g. 40 and 70 den) = no stiffness and little effect
- Medium stretch: elastic support stockings (e.g. 140 den) and light medical compression stockings = little stiffness and minor effect
- Short stretch: firm elastic medical compression stockings = high stiffness and major effect
it has been shown that a high stiffness index, i.e. low pliability of the stocking (similar to that of short stretch bandages), is associated with a more pronounced reduction in venous reflux when walking with a subsequent fall in ambulatory venous hypertension.
Stripping: operative removal of varicose veins by pulling them out. This is now the most frequently performed operation for removing diseased veins from the legs: a special probe is introduced into the varicose vein through a small incision either in the groin or in the ankle and is then used to pull the vein out.
Tactel: trade name for polyamide (nylon) from Invista
Thrombosis: blockage of a vein by a blood clot that forms in the veins and adheres to the vein walls. These blood clots are dangerous if they become dislodged and are swept into the lungs, since, once there, they can block a pulmonary artery to form a pulmonary embolism. The danger is understandable if one remembers that such a thrombus (clot) can weigh up to 5g and, during the passage through the heart, explodes into many small fragments which reach the lungs like shotgun pellets.
Two-way stretch compression stockings: these are stockings that are elastic in two directions at right angles to each other (transverse or longitudinal).
Ulcus cruris venosum: venous leg ulcer, the most serious complication of chronic venous insufficiency.
Varices: (varicose veins) are distended tortuous veins. Superficial varicose veins are easily visible or palpable, and follow a tortuous course through the subcutaneous fatty tissue (usually) of the legs. Varicosities of the deep venous system can only be seen on ultrasound or phlebography. As a result of the distension of the veins, the valves can no longer close properly; this is called valve insufficiency. The hydrostatic pressure exerted on the vessels in the lower part of the body is considerably increased. The “transmural” pressure, i.e. the difference between the pressure in the venous system and the surrounding tissues causes more water and dissolved substances to leak through the venous wall where it accumulates in the tissue, mostly of the leg (oedema).
Varicose veins: in the legs are more than just an annoying cosmetic blemish: they signal a susceptibility to venous disorders and they may even indicate a venous disease. However, varicose veins are not painful, neither do they cause cramps – the German word for varicose veins, ‘Krampfadern’, literally translates into English as cramp veins or, more precisely, cramp arteries. However, Krampf (cramp in English) actually stems from the old standard German word, "chrampo", which simply means “bent”. Varicose veins, also called varicosities, are saccular and distended veins which can expand considerably and may cause painful venous inflammation. They never disappear on their own once they have developed. The formation of varicose veins is an externally visible sign of venous weakness.
Varicosis: is the term for extensive varicose veins and the typical associated symptoms. Varicose veins are often – but not always – connected with the typical symptoms of chronic venous insufficiency. Varicose veins can develop in a number of ways: so-called primary varices are caused in people with congenital connective tissue weakness who frequently stand or sit for a considerable length of time, by a lack of exercise and during pregnancy. In contrast, so-called secondary varices are the result of pathological events in the deeper veins, usually a thrombosis.
Vein Sclerosis: form of treatment in which a medicament (sclerosant) is injected into the vein to permanently close and eliminate the varicose veins and spider veins.
Veins -> Wikipedia
Venous inflammation: = Phlebitis. Causes: poor diet, bacterial infection after an i.v. injection or infusion
Venous valves: non-return valves in the veins which only open when the blood is flowing towards the heart. -> Wikipedia
Working pressure: pressure exerted by a compression stocking or bandage on the leg while the muscles are active.
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X-Static®- The Silver Fiber: trade name for silver-coated polyamide nylon from Noble Biomaterials, Inc.
Yarns: fibres such as nylon, polyamide, elastane, cotton and elastodien are primarily used for stockings -> Wikipedia