However, they continued to apply the compression stockings on top of the dressings and subsequent deterioration was noted. This new ulcer was initially managed in the community by the district nursing team. The patient developed a new ulcer on the anterior aspect of his shin, proximal and lateral to the original ulcer, thought to be as a result of pressure from the compression stockings. Initially the stockings were beneficial and the ulcer resolved, however, their continual use subsequently caused problems. At that time it was noted that he was overweight and had chronic oedema of both legs and feet. He was initially referred to the vascular surgeons in 2002 with a venous ulcer on the medial aspect of his left ankle and it was recommended that he be treated conservatively with grade 3 compression stockings (40–60 mmHg). His past medical history includes type II diabetes and venous disease.
The patient is an 76-year-old male who lives alone in sheltered accommodation and mobilises with the aid of a zimmer frame. Although an extreme case, it highlights the importance of careful assessment, application, and monitoring of compression stockings. Here we present the case of an older male who was referred to a local plastic surgery service for the management of a pressure sore on the anterior aspect of his left lower leg as result of compression stocking application for the treatment of venous ulcer disease. Unevenly distributed and excess pressure may break the skin, especially in older, malnourished patients and those with thin, brittle skin. Although the application of compression stockings can appear simple, it must be remembered that inappropriately worn stockings have the potential to cause significant problems. Most patients admitted to hospital are automatically at a higher risk of developing thromboembolic disease and should therefore receive appropriate prophylaxis 2. Compression stockings play an important role in the management of venous disease, venous ulcers, and preventing thromboembolic disease of the deep venous system in the legs 1.
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