Graduated compression therapy usage among surgeons in the COSECSA region: A cross-sectional study

Abstract

Background: Numerous studies have demonstrated that graduated compression therapy (GCT) is efficacious in the management of venous disorders, as well as in the prevention of venous thromboembolism (VTE). 

This study aimed to delineate GCT usage by surgeons in the region served by the College of Surgeons of East Central and Southern Africa (COSECSA). 

Methods: We conducted a cross-sectional study among surgeons attending the 17th COSECSA Annual Scientific Conference in Mombasa, Kenya, between 7 and 10 December 2016. Only surgeons practising in the COSECSA region were included. Participation was voluntary, and those who consented were asked to complete a pretested questionnaire. 

Results: Ninety-four surgeons of various specialities submitted complete questionnaires. General and orthopaedic surgeons (48% and 30% of respondents, respectively) saw the most patients with venous disorders and patients at risk of VTE. Considering the mean number of patients seen, respondents prescribed GCT infrequently. Orthopaedic surgeons were the least likely to report having prescribed GCT for patients who might have benefited from such therapy, only doing so 15% of the time. The commonest indications for GCT prescription were varicose veins and VTE prophylaxis. The most commonly reported challenge was availability. No respondent reported experience with serious adverse events associated with GCT, such as limb ischaemia or nerve injury. A majority of the surgeons (58%) reported that GCT is effective for the prevention of VTE as well as the treatment of various venous disorders. 

Conclusions: GCT is widely accepted as a useful tool in the prevention of VTE and management of various venous disorders among surgeons in the COSECSA region. However, GCT usage is low, owing to challenges such as availability. 

Keywords: graduated compression therapy; compression stockings; venous insufficiency; venous thromboembolism; deep vein thrombosis; varicose veins; Africa