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VenoTrain cocoon study “Basically anyone will benefit from this stocking”

Issue 01/2018

What impact does the new VenoTrain cocoon medical compression stocking, with its integrated skincare complex, have on skin moisture levels in patients with venous disease? A research team at Greifswald University Hospital in Germany conducted a study to find out. life spoke with Study Director Prof. Dr. med. Michael Jünger, Director of the hospital’s clinic and polyclinic for skin conditions.

Bauerfeind life: Why do wearers of compression stockings often suffer from dry skin?
Prof. Dr. Jünger: A fifth of all venous patients are at an advanced stage of chronic venous insufficiency (CVI), which is in turn associated with chronic skin inflammation. This generally presents as brown discoloration on the skin of the lower legs. The skin is very sensitive and dry, and tends to be rough with scaliness and cracking.
As well as that , however, our skin gets drier generally as we age, since the sebaceous glands produce less sebum and the number of glands also decreases. Wearing compression stockings further exacerbates this drying process.

In what way?
Prof. Dr. Jünger: A compression stocking fits very closely, since it is designed to exert pressure on the skin and, therefore, on the problematic veins. And because the stocking fits so closely against the skin, it acts rather like a candle wick, transferring oil away from the skin and into the stocking. This effect is further compounded by shearing forces between the stocking and the skin.

Prof. Dr. Jünger shows the skin of a CVI patient with typical brown discoloration, who would benefit from the VenoTrain cocoon.
Prof. Dr. Jünger shows the skin of a CVI patient with typical brown discoloration, who would benefit from the VenoTrain cocoon.

What’s special about the new compression stocking and what did you investigate in your study?
Prof. Dr. Jünger: With the VenoTrain cocoon, we had the chance to use a very modern and innovative medical textile. Unlike traditional compression stockings, the VenoTrain cocoon has a lipid-replenishing skincare complex integrated in the stocking. This complex is applied to the skin while the stocking is being worn. In our study, we researched how important functional parameters of the skin barrier evolve when the compression stocking is worn.

What was your methodical approach?
Prof. Dr. Jünger: We were able to recruit 50 of our own patients with CVI for the study. First of all , we clinically examined all of the patients to ascertain the stage of their CVI. We then used duplex ultrasound to evaluate the blood flow in the veins so that we could establish the extent of the hemodynamic disruption. Half the patients, chosen at random, were given the medical compression stocking with the integrated skincare complex, while the other half were provided with a traditional compression stocking – it was a knee-high stocking in both cases. Before the patients started wearing the stockings, we measured the moisture level of a specific area of the skin on the lower leg using corneometry and determined the transepidermal water loss. We also measured the roughness of the skin and the leg volume. The study patients wore the compression stockings for at least eight hours a day for four weeks. We also asked them to fill in a quality of life questionnaire on a daily basis. After the four weeks, the patients were then examined and questioned, and we repeated the skin moisture level , transepidermal water loss, leg volume, and skin roughness measurements.

What were the key results?
Prof. Dr. Jünger: I must start by saying that the two stockings used in our study were equally effective in improving the blood flow in the veins and reducing edema.
In the case of the traditional compression stocking, we found evidence of the “candle wick” effect that I mentioned. In this group of patients, the skin moisture level dropped slightly over the four weeks, while the skin’s water vapor permeability increased slightly. We also found a greater degree of skin roughness. This is all down to the compression stocking irritating the skin if skincare isn’t provided at the same time. Compared to the control group, there was a smaller reduction in the skin moisture level in the group of patients who wore the VenoTrain cocoon. What’s more, the skin was actually smoother with the care stocking than it was with the traditional compression stocking.
There were two sub-groups which particularly benefited from the compression stocking with the integrated skincare complex. One of these sub-groups was the male patients, since men tend to have a lower level of moisture in their skin in the first place. We can speculate about the reasons for this, but there’s no doubt that one factor is that men generally don’t take care of their skin as well as women. The second sub-group to benefit significantly was patients with a CEAP 3 classification. Patients in this category not only have poor blood flow in their veins, but they already have clinical symptoms with edema.

What feedback did your patients give you about how comfortable the two stockings tested were to wear?
Prof. Dr. Jünger: Both of the stockings were very comfortable to wear, with no significant differences between them in that regard. The VenoTrain cocoon patients reported that it took them less time to put the stocking on. The stocking glides a little more easily over the skin, which is an advantage. Some people do find putting on a compression stocking a bit tricky. We recommend use of a donning aid in such cases. It’s perhaps also worth mentioning that people should wash their compression stockings every day to remove flakes of skin, since these can cause the stocking to slip otherwise.

Which patients would you particularly recommend the VenoTrain cocoon to?
Prof. Dr. Jünger: Basically anyone who wants or needs to wear medical compression stockings will benefit from this stocking’s integrated skincare. As for who in particular should wear the VenoTrain cocoon, based on the results of our study, I would suggest elderly people – especially elderly men – and patients who are already at an advanced stage of CVI with pathological changes to their skin. In other words, patients who are already showing signs of skin discoloration, scaliness, or rough skin should take skincare extremely seriously. And wearing a medical compression stocking with integrated skincare would certainly be one way of doing just that.

 

Images: Stefan Volk, Bauerfeind