Running head: REVIEW OF REFERENCES

Review of References: Granulated Compression Stockings

Kimberly Nix
Ferris State University

REVIEW OF REFERENCES
Abstract
The use of graduated compression stockings has been an area of controversy for many
years. There have been many studies conducted that have been in favor for the use of graduated
compression stockings and studies that have shown no real concrete evidence that supports the
use of graduated compression stockings. I will be discussing three articles of literature that
focuses on compression stockings and how it pertains to nursing.

REVIEW OF REFERENCES
Review of References: Granulated Compression Stockings

The purpose of this paper is to review the references I used in Nursing 324 and reflect
on what I gained intellectually. While reviewing the references; I will reflect on the credibility
of the source as well as if the source was a nursing journal.
Review
I will be discussing the use of graduated compression stockings and whether the use of the
compression stockings reduces the risk of developing a (DVT) deep vein thrombosis after
suffering a stroke. According to (Nieswiadomy, 2012. 2008), a referred journal is where the
subjects experts are chosen by the journals editorial staff and they evaluate the manuscripts. A
nonreferred journal has the editorial staff or consultants review the manuscripts. Based on my
knowledge a qualitative research is where the subjective meaning is concerned with an
individual. While quantitative research is concerned with objectively and has very tight controls
and has the ability to generalize findings.
Article One
The first article I chose discusses the use of graduated compression stocking and the
relevance of use in patients suffering from an acute stroke. A case study was performed on a 74
year old male. He was admitted to the hospital after suffering a stroke experiencing right arm
weakness and slurred speech. He was fitted with graduated compression stocking during his
admission for the prevention of DVT. Some of the concerns brought up in this article discussed
the risks of skin breakdown, blisters, necrosis, patient satisfaction, and skin ulcers (Xu, 2010.) In
my opinion; this article comes from a creditable source. The author is a basic physician trainee,
so I am unsure if this gentleman is nurse. The article conducts a randomized controlled trial,

REVIEW OF REFERENCES
which consists of multiple studies. In one study is concluded a non-significant reduction in DVT
with the use of graduated compression stockings. Another study concluded there was a
significant increase in skin break down, blisters, and necrosis, however; no reduction in DVTs.
The conclusion of the various studies indicated in these studies reflected no real significance
decrease in developing DVTs with the use of graduated compression stockings. The 74 year old
gentleman who suffered a stroke reported tightness in his lower extremities while wearing the
graduated compression stockings, but did not develop any acute skin problems. He received
rehabilitation after his stroke and continued to wear the graduated compression stockings during
rehabilitation. I believe this article is relevant to nursing and how we can better care for our
patients.
Article Two
The second article I chose was a study to determine if anti-embolism were worn
according to evidence based guidelines in surgical patients (Miller, 2011,) This study was based
on observation. With the use of an audit tool, information was collected by auditing eighty
surgical patients. The mean age was sixty-six years of age. The results of this audit reflected
that 29% of the patients were fitted with the incorrect size of anti-embolism stockings. Patients
did not receive written information explaining the graduated compression stockings. 82% of the
patients DVT risks were not recorded. Only 29% of the patients have daily skin inspection
documented. The conclusion of this study reflected that anti-embolism stockings were not fitted
and worn according to evidence based guidelines. This is a European based article originating
from Monash University. I believe this article to be a credible source. The article doesnt
specify if the author is a nurse, so I am unable to make that determination. I do not believe this
article came from a nursing journal.

REVIEW OF REFERENCES
Article Three
The last article I chose to review discussed the effectiveness of thigh-level graduated
compression stocking and how they may reduce the risk of developing a DVT after suffering a
stroke (Dennis, 2009.) This article originated from a medical journal. Based on the source of the
journal, I believe this to be a credible source. There is not clear distinction if the author is a
nurse, so I am unable to make that determination. 2518 patients that were admitted to the
hospital within one week after experiencing an acute stoke were immobile enrolled from 64
centres in the UK, Italy, and Australia. 10% of the patients have a non-significant reduction in
the risk of developing DVTs. Skin complications were more significantly more common in 5%
of the patients. The conclusion of this study did not reflect the support of the use of thigh-high
graduated compression stockings in patients post-acute stroke. I did not see the relevance of
this study. While I understood the most common side effects of the use of anti-embolic
graduated compression stockings, I did not have a clear understanding of the study.
Understanding the study was not nurse friendly. My opinion was that this study was focused
more on physicians that on nurses.
Reflection
After reviewing the articles I have a better understanding as to why the use of compression
stockings is extremely important and may reduce the patients risk of suffering a DVT after
suffering a stroke. Although the articles were different studies, they were all based on the use of
graduated compression stockings. I am not sure I would choose the third article for future
reference in regards for easy reading. I would however choose the third article for educational
purposes. The percentage that was used to inform us how many patients lacked the education in
regards to the used of anti-embolism stockings was very eye opening. Unfortunately, patient

REVIEW OF REFERENCES
education is an area that really needs to be focused on. While I believe articles that have a more
physician focused approach have great information to provide to us, it is sometimes more
difficult to understand. I would prefer to choose articles that have a more nurse focused
approach. I have used the knowledge I gained from these articles in my everyday nursing
practice. I would reference back to the articles when educating patients. I found these articles
to be very beneficial and very informative.

REVIEW OF REFERENCES
References
Xu, B. (2010). DVT in acute stroke: The use of graduated compression stockings. Australian Family
Physician, 39, 485-487. Retrieved from http://www.racgp.org.au/afp/201007/201007xu.pdf
Miller, J. A. (2011). Use and wear of anti-embolism stockings: A clinical audit of surgical patients.
International Wound Journal, 8, 74-83. Retrieved from
http://europepmc.org/abstract/MED/21251225/reload=0;jsessionid=gjyJ7iLLHTu1zWkhs5Y2.10
Dennis, M. (2009). Effectiveness of thigh-length graduated compression stockings to reduce the risk of
deep vein thrombosis after stroke (CLOTS trial 1): A multicenter, randomized controlled trial.
Lancet, 373, 1958-1965. Retrieved from
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736 (09)60941-7/abstract
Nieswiadomy, R. M. (2012. 2008). Foundations Of Nursing Research. Upper Saddle River: NJ.