The reader is referred to chapter 1 of this primer. Application of external compression should only be carried out after assessing the peripheral arterial circulation. Foam pads are utilized to provide increased local compression over incompetent perforating sites and around the malleoli. Graduated compression is used daily with the greatest measured compression at the foot and ankle. Patients with large calf and thigh circumferences as well as irregularly shaped legs may require custom fit stockings.
Several products are available to aid in the placement of the stocking.
With each stocking comes a foot sleeve to ease the stocking over the toes. Rubber gloves help the patient to grip the stocking. Metal rings are available to stretch the stocking in order to easily place it over pads that are sometimes used after sclerotherapy. . Anesthesia Surgical treatment of varicose veins may require general, regional, or local anesthesia. Sclerotherapy generally does not require anesthesia, although some patients benefit from oral anxiolytics or the topical application of EMLA cream.