A History of Quality - Kayra Medical · borne in mind that legs are easily compressible as they are made up of tissues that are actually elastic themselves and so the external compressive

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CIZETA MEDICALI S.p.A. comes from a long tradition of producing elastic compression products for safeguarding health and preventing disease.

Centenari & Zinelli, the very first Italian manufacturer of elastic compression fabrics to be listed on the Milan Stock Exchange, was set up back in 1872.

In 1936, the first elastic compression stocking for varicose veins was produced and within a short time Centenari & Zinelli specialized in this type of product for which it became the largest manufacturer in Italy.

In 1947, the first patent for a therapeutic knee-high stocking was filed.

In 1966, Centenari & Zinelli was listed on the Milan Stock Exchange, a recognition of the importance and solidity reached by the company.

A History of Quality

Therapeutic knee-high stocking patent, 1947.

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In 1982, the paramedical product sector, which was growing rapidly, was detached from the rest of the company and organized in an independent company under the name of Cizeta Paramedicali S.r.l.

The company’s strategy, increasingly oriented towards development of the medical line of stockings and the therapeutic segment in general, led to the company’s transformation into CIZETA MEDICALI S.p.A in the year 2000.

Today, the company’s mission is:“a continuous search for new solutions in the treatment of venous insufficiency and the treatment of lymphatic disorders, through innovative products, certified by recognized international institutes and backed up by a prestigious company tradition”.

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CIZETA MEDICALI S.p.A.’s manufacturing tradition, renewed with state-of-the-art technologies, is descended from the continuous search for high quality standards.

In fact, product quality is the key to success on both a national and international level.

The search for new technical solutions to improve product quality and fully computerized management of the production and distribution processes make CIZETA MEDICALI S.p.A. a highly-competitive leader on the market.

Today, CIZETA MEDICALI S.p.A manufactures its products in compliance with the principal international standards on patient protection and guarantees.

Certified Quality

Single-coated and double-coated yarn

Detail of woven fabric (electron microscope)

Detail of circular machine

Dynamometer for measuring compression

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UNI EN ISO 9001UNI CEI EN ISO 13485

Quality management system certification

UNI EN ISO 9001 and UNI CEI EN ISO 13485 Cizeta Medicali has a quality management system that complies with UNI EN ISO 9001 and UNI CEI EN ISO 13485 standards.Through this certification, obtained in 2001, Cizeta Medicali guarantees the highest quality products and services.

Direttiva CEE 93/42Dispositivo medico ClasseI

Class I Medical DeviceDirective EEC 93/42

CE markCizeta Medicali’s products are Class 1 Medical Devices and meet the requirements of Directive EEC 93/42, as amended.

In the specific therapeutic stocking sector, CIZETA MEDICALI S.p.A.’s products are certified at national and international level.

Compression profile of a RAL-GZ-387/1 certified stocking

CONTENTIONMEDICALE

CERTIFICAT DE QUALITé PRODUITS

A

ASQUALCertification issued by the ASQUAL Quality Association (France), which guarantees that the certified products comply with specifications of the NF G30-102B standard thus guaranteeing their quality.

eurocomEUROPEAN MANUFACTURERS FEDERATION FOR COMPRESSION THERAPY AND ORTHOPEDIC DEVICES

Cizeta Medicali is a founding member of Eurocom, the European association of manufacturers in the field of compression therapy and orthopaedic devices. All Eurocom members are manufacturers of medical compression stockings with RAL-GZ 387/1 certification.The association’s mission is to spread knowledge of the quality of RAL-GZ 387/1 certified stockings among patients and operators in the sector.

FDAThe Food and Drug Administration (FDA) is an agency of the United States Department of Health and Human Services. Cizeta Medicali products are accredited by the FDA, whose mission is to safeguard public health and ensure safety and efficacy.

OEKO-TEX STANDARD 100All therapeutic stockings, anti-hromboembolic stockings, therapeutic arm sleeves and other compression segments have Oeko-Tex certification to guarantee the absence of harmful substances and thus safeguard the user’s heath.

RALCertification issued by the Hohenstein Research Institute (Germany), which guarantees the quality of the stockings through periodic quality tests in accordance with the RAL-GZ 387/1 standard.

GÜTEZEICHEN

MEDIZINISCHE

KOMPRESSIONS-

STRÜMPFE

RAL

SFDAThe Chinese Health Department agency. Cizeta Medicali products are accredited by SFDA, whose mission is to safeguard public health and ensure safety and efficacy.

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CIZETA MEDICALI produces therapeutic and preventive elastic compression products that protect the upper and lower limbs against venous and lymphatic disorders.

The company’s extensive production know-how concerns circular-knit and flat-knit elastic compression products. Orthopaedic products and care for diabetic patients are also a part of the company’s culture.

All products are made using innovative technology and certified on an international level.

Before being placed on the market, the most important products are validated by clinical trials, the results of which are published in indexed international journals.

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Rationale for using preventive stockings in diabetics 68

VARISAN DIABETICSock for diabetics and sensitive feet 70

PhlebologyLine 9

PreventiveLine

MaternityLine

67

Venous circulation 10

The venous systemof the lower limbs 12

Compression therapyin venous disease 14

Clinical applications of elasticcompression therapy 19

Graduated compression 20

Compression classes 21

VARISAN TOPMedical compressionstockings 22

VARISAN TOPTerapeutic arm sleeve 24

VARISAN TOPTerapeutic glove 26

VARISAN TOPKnee-high stocking with zip 28

VARISAN FASHIONMedical compressionstockings 30

VARISAN FASHION INNOVAMedical compressionstockings 32

VARISAN CLASSICMedical compressionstockings 34

VARISAN SOFTMedical compressionstockings 36

VARISAN A.T.E.Anti-thromboembolicstockingsOpen toe 38

VARISAN A.T.E.Anti-thromboembolicstockingsInspection opening 40

VARISAN A.T.E.Anti-thromboembolicstockingsInspection opening 42

CIZETA PRESS®After-cast knee-highstocking 44

CIZETA PRESS® Elastic Bandages 45

DiabeticLine

47

Safeguarding the lower limbcirculatory system 48

Preventive knee-highstocking formen-women 50

Preventing the risk of deepvein thrombosis (DVT) 52

Fashion, style and comfort 53

VARISAN LUI & LEIKnee-high stocking for men/women 54

VIVARelaxing Stockings(graduated compression)

40 den 56

70 den 58

140 den 60

Why pregnancy aggravates or can cause venous diseases 70

Precautions 73

Which stocking should be used for venous circulation 75

VARISAN TOPMedical compression stockings 76

VARISAN SOFTMedical compression stockings 78

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Phlebology LineValvular incontinence or thrombotic obstruction create a state of hypertension in the major veins which, especially when standing, goes on to affect the legs as far as the finest branches of the microcirculation systems with the consequences described.

The ideal treatment for venous insufficiency should therefore resolve, or at least reduce as much as possible, the condition of venous hypertension to avoid resulting stress and cell death and severe damage to the skin, subcutaneous and muscle tissues.

Elastic compression therapy remains the best known, widely experimented and effective therapeutic tool at our disposal and is easily adaptable to the various expressions of venous disease. It is the only form of therapy capable of constantly counteracting the state of venous hypertension that causes tissue damage.

But how does elastic compression work? The first effect is to reduce the diameter of the veins, an effect that is most evident on the surface and progressively less so in depth. It should be borne in mind that legs are easily compressible as they are made up of tissues that are actually elastic themselves and so the external compressive force is gradually dispersed.

This consideration introduces the concept of personalizing compression. It is therefore evident that a different elastic support appliance will have to be chosen for each patient, according to his/her characteristics and disorder.

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The tissues of our body need to receive the substances that serve to perform the main functions and eliminate waste substances. These two extremely important actions are guaranteed by the blood circulation.

From the left side of the heart, the blood is pumped at a high pressure into the main arteries: the Aorta and its main branches (towards the arms, brain, internal organs and legs). Each of these branches splits in turn into trunks with a smaller diameter to reach the muscles or organs.

Venous circulation

The arteries carry blood at a high pressure, rich in oxygen and nutrients.

Inside the organs, the situation changes, the arteries split into increasingly small branches until they become microscopic: the capillaries.

The transport and circulation function is then replaced by a nutritional function, performed directly with the cells. In fact, the capillaries have extremely thin walls that enable an exchange of nutrients and waste products with the cells in the tissues.

Diagram of blood circulation. The metabolic tissue exchanges take place in the microcirculation.

Plantar venous pump and muscle pump

ARTERIEScoming from

the heart

VEINSgoing to the heart

ARTERIOLES

CAPILLARIES

VENULES

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Having flowed through the capillaries, the refluent blood, poor in oxygen and containing waste substances but also the products of cell activity, is collected by venules converging into increasingly large vessels, the veins, and flows back towards the right side of the heart.

Veins are transport vessels but differ considerably from arteries in the structure of their walls and their pressure, which is much lower than that of arteries.

The Arteriole-Capillary-Venule-Lymphatic vessel complex is defined a “microcirculatory functional unit”.

Some large molecules and many protein molecules are too big to penetrate the capillary walls. If they remain in the space between cells, they could have a toxic effect or, in any case, upset the delicate chemical and physical balance of the cells.

The lymphatic vessels originate in the interstitial spaces as blind vessels and can transport large molecules and anything that cannot be reabsorbed by the capillaries towards the heart via the main lymphatic ducts that flow into the subclavian veins.

Venous return is ensured by mechanisms that are effective in returning the blood to the heart, such as:

• The action of the venous valves.

• The plantar venous pump and calf muscle pump.

• Negative pressure in the chest when breathing in.

In the lower limbs, the situation is complicated further by the increase in hydrostatic pressure due to the standing position. When we are standing, for the blood to flow back up to the heart it has to overcome the force of gravity, which tends to hold it down.

Healthy venous system, normal blood flow Symptoms without clinical signs

Onset of inflammatory processes and tissue damage: leukocyte adhesion.

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From the anatomical point of view, the venous system of the lower limbs is made up of deep veins (which run between muscles) and superficial veins (which make up a complex network just below the skin).

The venous blood flows up the legs mainly through the deep veins and, to a slight degree, through the superficial veins.

The veins contain structures that allow the blood to flow in one direction only, that is, towards the heart: they are venous valves that stop the blood flowing back downwards due the force of gravity.

These valves alone, however, are not sufficient to push the venous blood upwards; what is needed is a force that replaces that of the heart.

The venous system of the lower limbs

A venous valve

Venous circulation in the lower limbs: the presence of working valves forces the blood to flow upwards and away from the surface in depth

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The pump formed by the leg muscles

There are structures in the foot that favour venous return.In fact, the sole of the foot is made up of spongy tissue with a complicated network of superficial and deep veins that is emptied through compression against the ground every time we take a step.

Through this mechanism, the blood is pushed up beyond the ankle to the calf where there is another device that pushes the blood up towards the heart: the calf muscles. As they contract, these muscles compress the deep veins in the leg and push the blood up to the groin.

The “peripheral heart” in the legs therefore consists of the combined action of the foot and the calf muscles, which force the blood upwards whenever our legs are in motion.

When the venous blood passes the groin and reaches the abdomen, another important mechanism is activated: respiration.The movement of the diaphragm, the muscle separating the thoracic cavity from the abdominal cavity, determines variations in pressure that make the blood flow from the abdomen to the chest and then to the heart.

To sum up, the venous blood flow in the legs is guaranteed by a series of mechanisms that enable the blood to return to the heart.

Lejars’ plexus

Telangiectasias

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Compression therapy in venous diseaseVenous disease is caused by an alteration of the circulation due to valvular insufficiency with backflow, venous hypertension and haemostasis, which in turn cause varices, tissue damage due to “static hypoxia” and venous ulcers.Chronic venous insufficiency may also contribute to create severe thrombotic conditions involving the superficial veins - varicothrombosis – or deep veins – deep vein thrombosis.

The treatment will be chosen on the basis of an accurate diagnosis and may be medical (pharmacology and compression), or surgical, for example, sclerosing.

Compression therapy may effectively contrast these effects, both in thrombotic diseases such as superficial and deep vein thrombosis, and following vein surgery and sclerotherapy of varices.

Also in chronic thrombotic diseases, it has clear indications in the treatment of varicose veins, oedema, trophic disorders of venous origin and venous ulcer.

Contraindications for pharmacological prophylaxis or in combination with it.Chronic prolonged confinement to bed.

Hypercoagulability caused by chronic venous stasis:

with increased thrombotic and embolic risk

Deep vein thrombosis. One leg swollen compared to the other.

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Acute thrombotic diseases

• Superficial vein thrombosis

Superficial thrombosis is often wrongly considered a benign disease in cases with no thrombophilic risk factors and generally a complication of varicose veins. Nevertheless, it may progress to pulmonary embolism with a fatal outcome.Alongside pharmacological treatment (anti-inflammatory/heparin), the role of elastic compression therapy (graduated compression bandages and stockings, always combined with walking) is becoming increasingly important in the indication for treatment and the prevention of disease progression.

RECOMMENDATIONSThe use of graduated compression stockings and walking are indicated for all patients with superficial thrombosis.

VARISAN Soft 10-15 mmHgIncrease in microcirculatory venous pressure

Deep vein thrombosis: incomplete thrombosis of the common femoral vein, colour Doppler US image.

• Deep Vein Thrombosis (DVT)

Preventing DVTA.T.E.® anti-thromboembolic, graduated elastic compression stockings reduce the incidence of post-surgery DVT with an optimum pressure of 18-21 mmHg at the ankle and 8 mmHg at the thigh.

RECOMMENDATIONSLow risk: graduated compression is recommended though insufficient data is available in medical literature.Moderate risk: elastic compression stockings combined with or as an alternative to heparin prophylaxis when contraindicated.High risk: as for moderate risk combined with several methods of prophylaxis.

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Treating DVT

Current DVT treatment remains based on the administration of heparin and oral anticoagulants.

Compression therapy and walking are fundamentally important from the very first day after the diagnosis of DVT, whether this disorder is treated in hospital or at home.

Applicable forms of compression therapy are stiff bandages and medical compression stockings with a pressure of 23-32 mmHg.

Preventing Post-Thrombotic Syndrome

Post-Thrombotic Syndrome (PTS) is caused by DVT with percentages of between 10% and 100% and presents moderate to invalidating oedema with pain, trophic and skin disorders, including ulceration.

RECOMMENDATIONSFollowing DVT, the patient should use an elastic compression stocking with a pressure of 23-32 mmHg for at least 2 years.Early compression helps to eliminate the thrombus more quickly.

Surgery

• Post-surgery compression and Post-sclerotherapy of varices

Post-surgery compression is indicated for the prevention of venous thromboembolism and post-operative complications.

RECOMMENDATIONSPatients undergoing active phlebology treatment (surgery and sclerotherapy) need to use medical compression stockings with a pressure of 18-21 mmHg or 23-32 mmHg for 2-4 weeks.

Results of the COM.PRE study: wearing a 23-32 mmHg elastic compression stocking immediately after the DVT diagnosis combined with walking ensures a more rapid and complete elimination of the thrombus.

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2

3

4

5

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8

Femoral vein

Popliteal vein

Dia

met

er in

mm

Baseline Day 14 Day 90

7.7 8

4.9 4 5 2

4.1 4

2.1 1.7 2.3 2

p< .05

p< .01

p< .01

p< .06

+_

+_

+_

+_

+_ +_

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• Varicose veins

Compression therapy is to be considered fundamental for the clinical management of patients with varicose veins due to its haemodynamic effects in reducing the feeling of heaviness, pain and tissue trophism, both alone and in combination with pharmacological treatment.

RECOMMENDATIONSThe use of compression therapy, in particular at a pressure of over 18 mmHg, is recommended.

• Oedema

Oedema is a common complication of venous insufficiency that occurs as early as the mild clinical stage but also in serious systemic heart, kidney and liver diseases.

It is manifested as an evening perimalleolar swelling in CVI, appears progressively and is more evident in varicose disease complicated by skin impairment and static ulcer.

The etiopathogenesis is represented by an upset of the interstitial pressure balance caused by venous hypertension.A role in preventing the formation of evening oedema seems to be played by the stretchability and stiffness coefficient (increase in compression in mmHg as the circumference of the limb increases) of the elastic support appliance.

Stockings with a high stiffness are more effective in contrasting the formation of oedema.

Chronic thrombotic diseases

RECOMMENDATIONSThe application of an external pressure of 20- 30 mmHg or 30-40 mmHg would improve the reabsorption of fluid, by increasing subcutaneous pressure, the best performance being obtained by 30-40 mmHg stockings.For mild evening oedema, stockings applying a pressure of 15-20 mmHg are more effective while an increase to 20-30 mmHg is recommended for patients with varices.For the maintenance and prevention of oedema relapse, elastic compression therapy with a knee-high or full-length stocking exerting a pressure between 15-35 mmHg at the ankle is indicated.

As indicated in the CIF guidelines

Ceap 2: varicose veins

Reticular veins

Reticular veins

OedemaEczema

Ulcer

Telangiectasia

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• Trophic disorders of venous origin: Skin pigmentation, Venous eczema, Hypodermitis, Cicatrized ulcer

The presence of skin alterations in chronic venous disease indicates severe tissue damage caused by hypoxia due to chronic stasis.

The presence of saphenous reflux and/or impairment of the deep venous circulation will influence the choice of the degree of compression to be adopted.

RECOMMENDATIONSIn the presence of saphenous reflux, the use of stockings applying a pressure of 30 mmHg at the ankle can improve both the clinical and the haemodynamic aspects.The presence of trophic disorders such as chronic oedema and hypodermitis, would require ankle pressure values of between 30 and 40 mmHg.Compression therapy is recommended in preventing ulcer relapse (30-40 mmHg at the ankle).

• Venous Ulcer

An effective treatment of venous ulcer is represented by compression therapy following local surgical and/or pharmacological cleansing, using elastic compression stockings, Unna bandages, multi-layer bandages and intermittent pneumatic compression.

Compression therapy, particularly at high pressure levels, improves the prognosis of this disorder.

RECOMMENDATIONSThe use of compression therapy in the treatment of venous ulcer caused by stasis (knee-high stockings with a pressure of 40 mmHg).

Skin pigmentation/Venous eczema /lipodermatosclerosis

Saphenous vein thrombosis. US scan image

HEAD Of THE THROMbUS

Healed/active venous ulcer

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Clinical applications of elastic compression therapyClinical experience and a wealth of literature support the efficacy of elastic compression therapy in the treatment of symptoms and prevention of complications of chronic venous insufficiency.

It has been demonstrated that the application of external compression counteracts the effects of haemostasis at least in part.

The application of elastic compression improves liposclerosis, ulceration and, in general, venous hypertension, thus controlling oedema and improving venous haemodynamics.

Compression therapy, in combination with other treatments, is indicated for all conditions of chronic or acute venous insufficiency.

Within groups of equivalent diseases, the type of compression, methods of application, and duration of use vary from one clinical condition to another and one patient to another; consequently, the choice of the compression support has to be adapted case by case to the needs of each individual patient and the severity of his disease.

Varicose veins, stagnant blood.

Due to the elastic compression exerted on the external part of the leg, the calibre of the veins returns to normal and their efficient functioning is restored.

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Graduated compressionWhen the pressure applied at the ankle is above 18 mmHg, the support appliance is defined “medical”.

It exerts a defined pressure on the lower limb that decreases from the bottom up with a pressure profile that must be 100% at point B (ankle), 70% at point C (calf ) and 40% at point G (thigh).

When speaking of compression therapy, the term “medical compression stocking” is used.

In fact, these products are designed and produced using special circular or flat machines that produce one stocking at a time, varying the knit and tension of the elastomer every few centimetres to obtain an effective decreasing compression that takes account of the anatomical features of the lower limbs and thus the natural variation in diameter.

In order to obtain a correct and uniform compression in all sizes, use is made of circular machines with at least three cylinders with different diameters and a different number of needles.

As the pressure value at each point depends on the percentage stretch of the stocking, compression will also depend on the circumference measurement and the shape of the leg.

For this reason, there is a size/measurement correspondence that, for each size, indicates the corresponding ankle measurements (POINT B) and also indicates the maximum acceptable circumference of the thigh (POINT G) without there being a tourniquet effect that could cancel out the benefit of the compression at the ankle.Overall measurement using a dynamometer

100%

70%

40%

Decreasing compression profile

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CONTENTIONMEDICALE


A

GÜTEZEICHEN

MEDIZINISCHE

KOMPRESSIONS-

STRÜMPFE

RAL

Compression classes

CIZETA MEDICALI specializes in the production of elastic compression supports used in the treatment of venous and lymphatic disease.

Elastic compression therapy remains the best known and most effective form of treatment that adapts best to various expressions of venous and lymphatic disease.

The application of external compression counteracts the effects of blood and lymph stasis.

The stocking model and compression class is to be chosen on the basis of the type of disease to be treated.

On the basis of the pressure applied, medical support appliances are available in 4 compression classes, expressed in mmHg.

INTERNATIONAL PRODUCT CERTIFICATIONS

Compressionclass

GÜTEZEICHEN

MEDIZINISCHE

KOMPRESSIONS-

STRÜMPFE

RAL

CONTENTIONMEDICALE


A

Ccl. 1 18-21 mmHg 10-15 mmHg

Ccl. 2 23-32 mmHg 15-20 mmHg

Ccl. 3 34-46 mmHg 20-36 mmHg

Ccl. 4 >49 mmHg >36 mmHg

Product certification in accordance with the German RAL-GZ 387 standard

Product certification in accordance with the French NF G 30-102 B standard

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GÜTEZEICHEN

MEDIZINISCHE

KOMPRESSIONS-

STRÜMPFE

RAL

CIRCUMFERENCE (cm)

Size 1 2 3 4 5NORMAL PLUS NORMAL PLUS NORMAL PLUS NORMAL PLUS NORMAL PLUS

Thigh 50-55 53-58 53-58 56-61 56-61 60-66 60-66 64-70 64-70 70-77

Calf 31-34 34-37 34-37 37-40 37-40 40-44 40-44 44-48 44-48 48-52

Ankle 19-20 21-23 23-25 25-27 28-30

LENGTH (cm)

Short NormalKnee-high stocking 36 - 41 42 - 48

Full-length stocking 66 - 73 74 - 82

COMPRESSION CLASS

REF. 18 - 21mmHg

23 - 32mmHg

34 - 46mmHg ARTICLE

Closed toe

623E1 624E1 Short knee-high stocking (AD)

623N1 624N1 Normal knee-high stocking (AD)

Open toe 6A3E1 6A4E1 6A5E1 Short knee-high stocking (AD)

6A3N1 6A4N1 6A5N1 Normal knee-high stocking (AD)

CA3E1 CA4E1 Short knee-high stocking (AD)

CA3N1 CA4N1 Normal knee-high stocking (AD)Closed toe

623E4 Short full-length stocking (AG)

623N4 Normal full-length stocking (AG)

Open toe 6A3E4 6A4E4 6A5E4 Short full-length stocking (AG)

6A3N4 6A4N4 6A5N4 Normal full-length stocking (AG)

CA3E4 CA4E4 Short full-length stocking (AG)

CA3N4 CA4N4 Normal full-length stocking (AG) Closed toe

623E9 624E9 Short self-supporting stocking (AD)

623N9 624N9 Normal self-supporting stocking (AD)

Open toe

6A4E9 6A5E9 Short self-supporting stocking (AD)

6A4N9 6A5N9 Normal self-supporting stocking (AD)

COMPRESSION CLASS

REF. 18 - 21mmHg

23 - 32mmHg

34 - 46mmHg ARTICLE

Closed toe 623E2 Short right single-leg tights (AGTR)

623N2 Normal right single-leg tights (AGTR)

623E3 Short left single-leg tights (AGTL)

623N3 Normal left single-leg tights (AGTL)

Open toe

6A3E2 6A4E2 6A5E2 Short right single-leg tights (AGTR)

6A3N2 6A4N2 6A5N2 Normal right single-leg tights (AGTR)

6A3E3 6A4E3 6A5E3 Short left single-leg tights (AGTL)

6A3N3 6A4N3 6A5N3 Normal left single-leg tights (AGTL)

CA3E2 CA4E2 Short right single-leg tights (AGTR)

CA3N2 CA4N2 Normal right single-leg tights (AGTR)

CA3E3 CA4E3 Short left single-leg tights (AGTL)

CA3N3 CA4N3 Normal left single-leg tights (AGTL)Closed toe

6235E 6245E Short tights (AT)

6235N 6245N Normal tights (AT)

Open toe

CA3E5 CA4E5 Short tights (AT)

CA3N5 CA4N5 Normal tights (AT)

Closed toe

623GE Short maternity tights (ATU)

623GN Normal maternity tights (ATU)

Phlebology Line Medical compression stockings

TOP

B

C

G

G

D

A

Products with cotton in contact with the skin

also available made to measure

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GÜTEZEICHEN

MEDIZINISCHE

KOMPRESSIONS-

STRÜMPFE

RAL

Compression classes available

Class Compression in mmHg

I 18 - 21II 23 - 32III 34 - 46

CharacteristicsThe VARISAN® TOP line is RAL certified and available in 5 sizes and 2 lengths.The product is very comfortable as it is made of a multifilament yarn, which makes the stocking soft, easier to put on and allows it to breathe.Many products are available with cotton in contact with the skin.All the articles in this line can also be made to measure.

IndicationsCLASS I (18 - 21 mmHg) standard and made to measureVarices, varices during and after pregnancy, initial venous oedema, reticular veins.CLASS II (23 - 32 mmHg) standard and made to measureSuperficial vein thrombosis, acute deep vein thrombosis, lymphoedema, prevention of post-thrombotic syndrome.CLASS III (34 - 46 mmHg) standard and made to measureValvular insufficiency of the deep veins, prevention of ulcer relapse, lymphoedema, post-thrombotic syndrome with severe skin tissue impairment.

ContraindicationsAcute dermohypodermitis, skin infections, peripheral obliterant arteriopathy, known contact allergy to elastic support appliances.

Duration of treatmentCompression therapy with VARISAN® medical compression stockings should only be given during the daytime. The stocking is to be put on in the morning, if possible before getting up, and taken off in the evening, before going to bed.During rest, in fact, the compression exerted could prove to be excessive.For short afternoon rests there is no need to remove the stocking.We recommend as much walking as possible during the daytime.

GuaranteeThe high quality of the materials used to make the VARISAN® elastic compression support appliance and the technologies adopted in their production guarantee the product for 6 months starting from the first time it is worn, providing the user instructions are followed.

739 beige

Colours

TOP

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Therapeutic arm sleeve

CIRCUMFERENCE (cm)

Size S M L

Arm 25 - 29 29 - 33 33 - 38

Forearm 21 - 25 25 - 29 29 - 33

Wrist 15 - 18 18 - 21 21 - 24

COMPRESSION CLASS

REF. 23 - 32 mmHg ARTICLE

6C444 Short arm sleeve to wrist

6L444 Long arm sleeve to wrist

6C445 Short arm sleeve to metacarpus with thumb

6L445 Short arm sleeve to metacarpus with thumb

6C449 Short self-supporting arm sleeve to metacarpus

6L449 Long self-supporting arm sleeve to metacarpus

LENGTH (cm)

Short Long< 45 > 45

F

D

C

C

G



TOP

25

CharacteristicsThe VARISAN® TOP arm sleeve line is available in 3 sizes and 2 lengths. All the articles in this line are also available made to measure.The upper hem is coated with silicone to ensure it adheres to the limb.All products have cotton in contact with the skin. Also available in a version with a support belt.

IndicationsCLASS II (23 - 32 mmHg) standard and made to measureTreatment of lymphoedema of the upper limb, post-thrombotic syndrome, maintenance of the results obtained with adequate treatment of the lymphoedema.

ContraindicationsAcute lymphangitis or erysipelas, secreting skin lesions, infections, known contact allergy to elastic support appliances.

Duration of treatmentCompression therapy should only be given during the daytime. The sleeve is to be put on in the morning, if possible before getting up and taken off in the evening.We recommend exercising the limb during the daytime.

739 beige

Colours



II 23 - 32

TOP

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Therapeutic glove

CIRCUMFERENCE (cm)

Size S M L

18 - 20 20 - 22 22 - 24

19 - 21 21 - 23 23 - 25

COMPRESSION CLASS

REF. 23 - 32 mmHg ARTICLE

6A443 Multistretch cotton glove

LENGTH (cm)

3 - 5 cm

9 - 12 cm C

B

A



TOP

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CharacteristicsThe VARISAN® TOP glove line is available in 3 sizes.All products have cotton in contact with the skin.All the articles in this line are also available made to measure.

IndicationsCLASS II (23 - 32 mmHg) standard and made to measure

Treatment of lymphoedema of the upper limb, maintenance of the results obtained through adequate treatment of lymphoedema of the arm and hand.

ContraindicationsAcute lymphangitis or erysipelas, secreting skin lesions, infections, known contact allergy to elastic support appliances.

Duration of treatmentCompression therapy should only be given during the daytime. The sleeve is to be put on in the morning before getting up and taken off in the evening.We recommend exercising the limb during the daytime.

739 beige

Colours



II 23 - 32

TOP

28

B

C

G

G

D

A

Phlebology Line Knee-high stocking with zip

COMPRESSION CLASS

REF. 34 - 46mmHg ARTICLE

Open toe

DX5E1 Right knee-high stocking (AD)with side zip, short

DX5N1 Right knee-high stocking (AD)with side zip, normal

SX5E1 Left knee-high stocking (AD)with side zip, short

SX5N1 Left knee-high stocking (AD)with side zip, normal

64002Knee-high understocking (AD)Stretch cottonOne size

CIRCUMFERENCE (cm)


Calf 31-34 34-37 34-37 37-40 37-40 40-44 40-44 44-48 44-48 48-52

Ankle 19-20 21-23 23-25 25-27 28-30

LENGTH (cm)


GÜTEZEICHEN

MEDIZINISCHE

KOMPRESSIONS-

STRÜMPFE

RAL



TOP

29

CharacteristicsThe VARISAN® TOP stocking with zip is RAL certified and available in 5 sizes and 2 lengths.The product is very comfortable as it is made of a multifilament yarn, which makes the stocking soft, easier to put on and allows it to breathe.Particularly indicated in the treatment of venous ulcer that requires medication, due to the cotton understocking and side zip.This article is also made to measure.

IndicationsCLASS III (34 - 46 mmHg) standard and made to measure For the treatment of ulcus cruris venosum (venous ulcer).


Duration of treatmentCompression therapy with VARISAN® medical compression stocking should only be given during the daytime. The stocking is to be put on in the morning, if possible before getting up, and taken off in the evening, before going to bed.During rest, the compression exerted could prove to be excessive.For short afternoon rests there is no need to remove the stocking.We recommend as much walking as possible during the daytime.




III 34 - 46

739 beige

Colours

GÜTEZEICHEN

MEDIZINISCHE

KOMPRESSIONS-

STRÜMPFE

RAL

TOP

30

B

C

G

G

D

A

CIRCUMFERENCE (cm)

Size 1 2 3 4

Thigh 49 - 56 54 - 62 59 - 67 64 - 74

Calf 29 - 35 33 - 40 38 - 45 42 - 48

Ankle 19 - 21 22 - 24 25 - 27 28 - 30

LENGTH (cm)


Full-length stocking 66 - 73 74 - 82


FASHION

COMPRESSION CLASS

REF. 18 - 21mmHg

23 - 32mmHg ARTICLE

F23E1

F23N1

F24E1

F24N1

Closed toe short knee-high stocking (AD

Closed toe normal knee-high stocking (AD)

F23E9

F23N9

F24E9

F24N9

Closed toe short self-supporting stocking (AG)

Closed toe normal self-supporting stocking (AG)

F23E5

F23N5

F24E5

F24N5

Closed toe short tights (AT)

Closed toe normal tights (AT)

GÜTEZEICHEN

MEDIZINISCHE

KOMPRESSIONS-

STRÜMPFE

RAL

31

CharacteristicsThe VARISAN® FASHION line is RAL certified and available in 4 sizes and 2 lengths.The product is very comfortable as it is made of a multifilament yarn, which makes the stocking soft, easier to put on and allows it to breathe. Its variety of colours encourages greater use in day-to-day life.

Indications

CLASS I (18 - 21 mmHg) Varices, varices during and after pregnancy, initial venous oedema, reticular veins.

CLASS II (23 - 32 mmHg) Superficial vein thrombosis, acute deep vein thrombosis, lymphoedema, prevention of post-thrombotic syndrome.


Duration of treatmentCompression therapy with VARISAN® medical compression stocking should only be given during the daytime. The stocking is to be put on in the morning, if possible before getting up and taken off in the evening, before going to bed.During rest, the compression exerted could prove to be excessive.For short afternoon rests there is no need to remove the stocking.We recommend as much walking as possible during the daytime.




I 18 - 21II 23 - 32

FASHION

Colours

620 llama

720 coffee

862 black

GÜTEZEICHEN

MEDIZINISCHE

KOMPRESSIONS-

STRÜMPFE

RAL

32

B

C

G

G

D

A

CIRCUMFERENCE (cm)

Size 1 2 3 4

Calf 29 - 35 33 - 40 38 - 45 42 - 48

Ankle 19 - 21 22 - 24 25 - 27 28 - 30

LENGTH (cm)

Normal LongKnee-high stocking 36 - 41 42 - 48

COMPRESSION CLASS


Closed toe

634N8 Normal knee-high stocking (AD)

634L8 Long knee-high stocking (AD)


FASHIONINNOVA

GÜTEZEICHEN

MEDIZINISCHE

KOMPRESSIONS-

STRÜMPFE

RAL


33

CharacteristicsThe VARISAN® FASHION INNOVA knee-high stocking is RAL certified and available in 4 sizes and 2 lengths.It has the appearance of a fashion product but the same characteristics as a class II medical stocking, with cotton in contact with the skin. Its pleasing appearance overcomes the reluctance of many patients to wear a beige stocking. The microfibre yarn gives the stocking excellent breathability.

IndicationsCLASS II (23 - 32 mmHg) Superficial vein thrombosis, acute deep vein thrombosis, lymphoedema, prevention of post-thrombotic syndrome.






II 23 - 32

FASHIONINNOVA

862 black

Colours

GÜTEZEICHEN

MEDIZINISCHE

KOMPRESSIONS-

STRÜMPFE

RAL

34

B

C

G

G

D

A

CIRCUMFERENCE (cm)

Size 1 2 3 4 5

Thigh 50 - 55 53 - 58 56 - 61 60 - 66 64 - 70

Calf 31 - 34 34 - 37 37 - 40 40 - 44 44 - 48

Ankle 19 - 20 21 - 23 23 - 25 25 - 27 28 - 30

LENGTH (cm)

1 2 3 4 5Knee-high stocking 39-42 40-43 41-44 42-45 43-47

Full-length stocking 66-72 69-75 72-78 75-81 78-84


CLASSIC

COMPRESSION CLASS

REF. 18 - 21mmHg

23 - 32mmHg ARTICLE

Open toe

6A301 62401 Knee-high stocking (AD)

Open toe

6A304 62404 Full-length stocking (AG)

Open toe

62409 Self-supporting stocking (AG)

Open toe

62452 Right single-leg tights (AGTR)

62453 Left single-leg tights (AGTL)

COMPRESSION CLASS

REF. 18 - 21mmHg

23 - 32mmHg ARTICLE

Closed toe

62301 Knee-high stocking (AD)

Closed toe

62304 Full-length stocking (AG)

Closed toe


Closed toe



GÜTEZEICHEN

MEDIZINISCHE

KOMPRESSIONS-

STRÜMPFE

RAL

35

CharacteristicsThe VARISAN® CLASSIC line is RAL certified and available in 5 sizes: the length of the stocking increases with the size.The product is very comfortable as it is made of a yarn that makes the stocking soft, easier to put on and allows it to breathe.

IndicationsCLASS I (18 - 21 mmHg) Varices, varices during and after pregnancy, initial venous oedema, reticular veins.CLASS II (23 - 32 mmHg) Superficial vein thrombosis, acute deep vein thrombosis, lymphoedema, prevention of post-thrombotic syndrome.



GuaranteeThe high quality of the materials used to make the VARISAN® elastic compression support appliance and the technologies adopted in their production guarantee the product for 6 months starting from the first time it is worn, providing the user instructions are followed. 306 flesh

Colours

CLASSIC



I 18 - 21II 23 - 32

GÜTEZEICHEN

MEDIZINISCHE

KOMPRESSIONS-

STRÜMPFE

RAL

36

B

C

G

G

D

A

CONTENTIONMEDICALE


A

CIRCUMFERENCE (cm)

Size 1 2 3 4

Thigh 50 - 56 53 - 59 56 - 62 59 - 65

Calf 29 - 32 32 - 36 36 - 40 40 - 44

Ankle 18 - 20 20 - 23 23 - 26 26 - 29


SOFT

COMPRESSION CLASS

REF. 10 - 15mmHg

15 - 20mmHg ARTICLE COLOURS

MF301 MF401 Knee-high stocking (AD), closed toe

120750850862

RB401 Knee-high stocking (AD), closed toe, diamonds

120780862

ST401 Knee-high stocking (AD), closed toe, silk

310862

MF309 MF409 Self-supporting stocking (AG), closed toe

120750850862

ST409 Self-supporting stocking (AG), closed toe, silk

310862

MF351 MF451 Tights (AT), closed toe

120750850862

MF341 MF441 Maternity tights (ATU), closed toe

120750862

37

CONTENTIONMEDICALE


A



I 10 - 15II 15 - 20

CharacteristicsThe VARISAN® SOFT line is ASQUAL certified and available in 4 sizes and 1 length.The product is very pleasing to the touch and the eye and is available in several different colours.

Indications10 - 15 mmHg15 - 20 mmHgMild functional symptoms of venous insufficiency, reticular veins, ectasia.

Contraindications

Acute dermohypodermitis, skin infections, peripheral obliterant arteriopathy, known contact allergy to elastic support appliances.

Duration of treatment

Compression therapy with VARISAN® medical compression stocking should only be given during the daytime. The stocking is to be put on in the morning, if possible before getting up and taken off in the evening, before going to bed.During rest, the compression exerted could prove to be excessive.For short afternoon rests there is no need to remove the stocking.We recommend as much walking as possible during the daytime.


SOFT

Colours

120 pink beige

750 fawn

780 chocolate

850 mocha

862 black

38

B

C

G

G

D

A

CIRCUMFERENCE (cm)

Size 1 2 3 4 5Thigh 45 - 50 50 - 55 55 - 60 60 - 65 65 - 70

Calf 27 - 31 31 - 35 35 - 39 39 - 43 43 - 47

Ankle 18 - 21 21 - 23 23 - 23.5 25.5 - 29 29 - 32

LENGTH (cm)

1 2 3 4 5Knee-high stocking 35-37 37-39 39-41 41-43 43-45

Full-length stocking 64-70 68-74 72-78 76-82 80-86

Phlebology Line Anti-thromboembolic stockings

Open toe

COMPRESSION CLASS

REF. 18 mmHg ARTICLE

Open toe

62201 Knee-high stocking (AD)

Open toe

62204 Full-length stocking (AG)

Open toe


Open toe



39

CharacteristicsThe VARISAN® A.T.E.® line is available in 5 sizes and 1 length with an open toe and fitted heel.Stockings for preventing deep vein thrombosis with a decreasing compression gradient.

Indications18 mmHgProphylaxis of deep vein thrombosis and pulmonary thromboembolism in post-operative and bedridden patients, when the use of pharmacological prophylaxis is contraindicated or in combination with it.


Duration of treatment with VARISAN stockingsThe VARISAN® A.T.E.® stocking should be used by the patient before, during and after an operation, after childbirth or while bedridden.

GuaranteeThe VARISAN® A.T.E.® stocking may be sterilized by washing at 90 degrees.

161 white

Colours


Compression in mmHg

18

G

G

D

A

C

B

Taglia/SizeCavigliaAnklePolpaccioCalfCosciaThigh

CIRCONFERENZA/CIRCUMFERENCE (cm)B

C

G

AD

AG

LUNGHEZZA/LENGHT (cm)GambalettoKnee-highCalzaThigh-high

1

18 - 21

27- 31

45 - 50

1

35 - 37

64 - 70

2

21 - 23

31 - 35

50 - 55

2

37 - 39

68 - 74

3

23 - 25,5

35- 39

55 - 60

3

39 - 41

72 - 78

4

25,5 - 29

39- 43

60 - 65

4

41 - 43

76 - 82

5

65 - 70

29 - 32

43 - 47

5

43 - 45

80 - 86

Made in Italy by CIZETA MEDICALI S.p.A.Via IV Novembre 46 - 20012 Cuggiono (MI)www.cizetamedicali.com

Azienda con sistema di qualità certificato secondo UNI EN ISO 9001Direttiva CEE 93/42Dispositivo medico Classe IClass I Medical DeviceDirective EEC 93/42

LA

TE

X F

RE

E

Calza anti-trombo-embolicaAnti-embolism-stockingAnti-embolism StrümpfeMedias anti-émboloKousen aangetrokken

40

B

C

G

G

D

A


Inspection opening

CIRCUMFERENCE (cm)

Size S M L XL XS SXL MXL LXL

Thigh 48-60 56-70 64-80 40-50 60-70 70-80 80-90

Calf 30-36 34-40 38-44 42-49

Ankle 20-22 23-25 26-28 26-28 17-19 20-22 23-25 26-28

Size

Knee-high stocking

Self-supporting single-leg

tights

COMPRESSION CLASS


RP201 Knee-high stocking (AD)

RP209 Self-supporting stocking (AG)

CP209 Self-supporting stocking (AG)

RP252 Right single-leg tights (AGTR)

RP253 Left single-leg tights (AGTL)

CP250 Ambidextrous single-leg tights


41

CharacteristicsThe VARISAN® A.T.E.® line is available in 8 sizes and 1 length with toe inspection opening and reinforced heel in different colours according to size.Stocking for preventing deep vein thrombosis with decreasing compression gradient.

Indications18 mmHgProphylaxis for deep vein thrombosis and pulmonary thromboembolism in postoperative and bedridden patients, when the use of pharmacological prophylaxis is contraindicated or in combination with it.


Duration of treatmentThe VARISAN® A.T.E.® stocking should be worn by the patient before, during and after an operation, after childbirth or while bedridden.



Compression in mmHg

18

161 white

Colours

G

G

D

A

B

Taglia/Size

CavigliaAnkle

CosciaThigh

CIRCONFERENZA/CIRCUMFERENCE (cm)

B

G

LUNGHEZZA/LENGHT (cm)CortoShortNormaleNormal

S

19 - 21

52 - 57

ADfino a 38 cm.until 38 cm.oltre 38 cm.over 38 cm.

M

22 - 24

58 - 63

L

25 - 27

64 - 69

XL

28 - 30

70 - 75



LA

TE

X F

RE

E

AGfino a 74 cm.until 74 cm.oltre 74 cm.over 74 cm.

in 2lunghezze


42

B

G

G

D

A


CIRCUMFERENCE (cm)

Size S M L XL

Thigh 52 - 57 58 - 63 64 - 69 70 - 75

Ankle 19 - 21 22 - 24 25 - 27 28 - 30

COMPRESSION CLASS


6P2E1 Knee-high stocking (AD), short

6P2N1 Knee-high stocking (AD), normal

6P2E4 Full-length stocking (AG), short

6P2N4 Full-length stocking (AG), normal

6P2E9 Self-supporting stocking (AG), short

6P2N9 Self-supporting stocking (AG), normal

6P2E2 Right single-leg tights (AGTR), short

6P2E3 Left single-leg tights (AGTL), short

6P2N2 Right single-leg tights (AGTR), normal

6P2N3 Left single-leg tights (AGTL), normal

Inspection opening

LENGTH (cm)

Short NormalKnee-high stocking < 38 > 38

Full-length stocking < 74 > 74

43

CharacteristicsThe VARISAN® A.T.E.® line is available in 4 sizes and 2 lengths with toe inspection opening and a reinforced heel. The sizes are differentiated by a coloured ring on the toe of the stocking.Stocking for preventing deep vein thrombosis, with a decreasing compression gradient.

Indications18 mmHgProphylaxis for deep vein thrombosis and pulmonary thromboembolism in postoperative and bedridden patients, when the use of pharmacological prophylaxis is contraindicated or in combination with it.


Duration of treatmentThe VARISAN® A.T.E.® stocking should be worn by the patient before and after an operation, after childbirth or while bedridden.



Compression in mmHg

18

161 white

Colours

G

G

D

A

B

Taglia/Size

CavigliaAnkle

CosciaThigh

CIRCONFERENZA/CIRCUMFERENCE (cm)

B

G

LUNGHEZZA/LENGHT (cm)CortoShortNormaleNormal

S

19 - 21

52 - 57

ADfino a 38 cm.until 38 cm.oltre 38 cm.over 38 cm.

M

22 - 24

58 - 63

L

25 - 27

64 - 69

XL

28 - 30

70 - 75



LA

TE

X F

RE

E

AGfino a 74 cm.until 74 cm.oltre 74 cm.over 74 cm.

in 2lunghezze


44

CharacteristicsCompression decreasing from the malleolus to the calf, multistretch, made of elastomer and polyamide on the outside and cotton on the inside, with anallergic and breathability properties.

Indications Recommended for the period following the removal of casts to prevent/reduce ankle and/or leg oedema.

Contraindications


After-cast knee-high stocking

CIRCUMFERENCE (cm)

Size 1 2 3 4

Ankle 18 - 20 21 - 33 24 - 27 28 - 30

B

D

A

COMPRESSION CLASS


65001Knee-high stocking (AD), post-plaster, open toe

739 beige

Colours



II 23 - 32


CIZETA PRESS ®

45

CharacteristicsMono and bielastic bandages, beige, packed in cellophane and boxed.Various stretches and heights.

Indications Recommended in the prophylaxis and treatment of venous insufficiency and orthopaedic treatment of sprains, dislocations and bruises.It is to be applied exclusively by expert staff.

Contraindications


Elastic bandages

739 beige

Colours

REF. HEIGHT

6 cmHEIGHT

8 cmHEIGHT

10 cmHEIGHT

12 cm ARTICLE

CIZETA B 65110 65112Medium tension bielastic bandage

CIZETA BF 65210 65212High tension bielastic bandage

CIZETA M 65510 65512Medium tension monoelastic bandage

CIZETA MF 65610 65612High tension monoelastic bandage

CIZETA UB 65706 65708 65710 65712 Low stretch

CIZETA PRESS ®

46

47

Preventive Line

A sedentary lifestyle, age and obesity can in the long term cause the onset of venous disease. Effective prevention may be exercised using ad hoc products.Preventive stockings are graduated in deniers and guarantee compression at the ankle only, which decreases as the radius (i.e. circumference of the limb) increases.These stockings are usually reserved for preventing disorders typical of common phlebopathy diseases, such as heavy legs or slight swelling around the ankle after standing for long periods.They are well tolerated as they are easy to put on, are pleasing to the eye and touch, as they are highly transparent and available in several colours.

48

Safeguarding the lower limb circulatory system Chronic venous insufficiency is a progressive disease with major consequences on the quality of life if no adequate prophylaxis or treatment is given, so it is important to prevent its onset.

After a long day standing or sitting, many people, above all women, suffer an unpleasant feeling of tiredness, heaviness and pain in the legs often accompanied by cramp at night.

Prolonged standing or sitting and hormonal or heat-induced vasodilation lead to blood stagnation, which is at its maximum at the ankle and gradually decreases up the leg, and, in any case, increases venous pressure to the point that liquid leaves the circulatory bed, causing interstitial oedema.

Without muscular activity, this situation does not improve and tends to become chronic.

An initial objective is therefore to improve the venous circulation in the legs and the associated symptoms; the second is to avoid a deterioration in the condition and the appearance of complications.

49

The benefits of preventive stockings

Many types of stockings that may be defined elastic are available on the market but there are marked differences between them.

Stockings used for prevention must have a particular characteristic: they must exert maximum pressure at the ankle and then decrease pressure up towards the thigh, so as to favour the upward flow of blood.

Preventive stockings have a low compression force and are especially useful in preventing circulatory problems developing in persons with one or more risk factors (e.g. obesity, constipation, sedentary lifestyle, family history, use of oral contraceptives) and to mitigate the feeling of tiredness and heaviness of the legs.

The compression force at the ankle is expressed in millimetres of mercury (mmHg).“Den” (deniers) are a unit of measurement that indicate the thickness (weight) of the yarn used to manufacture these stockings.

The higher the number of “den”, the larger the quantity of elastic material per metre of thread, and the greater the compression exerted.

50

Preventive knee-high stocking for men-women

Preventing

venous disease

The most important piece of medical equipment for the treatment and prevention of venous insufficiency in men and women is, without doubt, the knee-high stocking.A knee-high stocking is an elastic compression appliance that reaches just below the knee.

The knee-high stocking acts on the most important physiological pumps, combining forces with them in order to favour the return of venous blood to the heart:

• Plantar venous pump:Having performed its nutritional function in the tissues of the foot, the arterial blood starts to return to the heart as venous blood through a closely knit network of capillaries and venules located in the sole of the foot.The rhythmic movement of the sole of the foot during walking squeezes these venules giving the blood an initial push upwards.The men’s/women’s stockings offer a compressive action, which starts immediately behind the toes, so they have a pumping effect also on the sole.

• Aponeurotic pump:The ankle represents a crucial point for venous blood return.Also in this case, it is through walking that the veins in the skeletal muscle system are squeezed rhythmically, thus speeding up the blood flow.

CIZETA MEDICALI knee-high stockings exert maximum compressive force at the ankle.In addition, they adhere perfectly also to the retromalleolar spaces due to their particular fineness and the nature of the elastomer used.This ensures their second, aponeurotic pump effect.

51

• Muscle pump:Above the ankle, the compression force of the men’s/women’s knee-high stockings starts to decrease gradually: considering the value at the ankle to be 100, the compression exerted on the calf is 60-70.This decrease reflects exactly the physiological values of the intravenous pressure at the calf: higher values would obstruct the return of the blood (tourniquet effect), aggravating the stasis at the ankle; lower values would have no synergistic effect with the calf muscle.

In fact, during walking the calf muscle contracts, giving the blood in the veins that run directly under the muscle an additional push.With their correct decrease in compression values, the men’s/women’s knee-high stockings work in the same direction as the muscle and thus also increase the “muscle pump” effect.It is this triple pump effect of the CIZETA MEDICALI knee-high stockings that decreases the venous pressure values with a consequent reduction in venous stasis.

The men’s/women’s knee-high stockings subjectively reduce ankle swelling, help to eliminate blemishes and free the individual from that heavy and tired feeling in the legs.

52

Preventing the risk of deep vein thrombosis (DVT)

(“Economy Class” Syndrome)

Environmental conditions like those created during long flights, but also long journeys in other means of transport (even at a lower risk due to the lack of changes in air pressure and oxygen tension) may increase the risk of DVT.

In fact, travelling often entails remaining seated for a long time; a major consequence of this is that the blood circulation slows down and the blood tends to clot (risk of thrombosis).

This risk may even affect people with healthy veins and increases with age.

One problem with DVT is that it is often not diagnosed in that it may not affect the entire lumen of the deep veins, it does not block the venous flow completely and does not cause the limb to swell. In addition, the risk of embolism is completely independent of the size of the thrombus.

53

PrecautionsAlongside the health and behavioural Precautions (also recommended by airlines, such as drinking water, avoiding alcohol, walking during the flight, etc.), a preventive measure that has proven to be effective in avoiding this disease is the use of elastic compression knee-high stockings.

While, to ensure the correct size is chosen, medical therapeutic stockings require a complex measurement of various leg diameters and lengths, the VARISAN® Lui&Lei knee-high stocking is chosen simply according to the length of the foot. In addition, it is light, cool, easy to put on and, above all, perfectly comparable to a normal men’s sock in terms of appearance.

Preventive stockings exert a beneficial, active massage that stimulates the circulation, reduces tiredness, heaviness and swelling of the legs, combining functionality with appearance, fashion and beauty.

In fact, several types of preventive stockings are available on the market with numerous solutions for every need, from traditional models (stockings and tights), to fashionable models (self-supporting stockings, knee high stockings etc.); they are generally light, transparent and available in a wide range of colours.

fashion, style and comfort

54

Size 1 2 3 4

Foot 37 - 39 39 - 41 41 - 43 43 - 45

Size 5 - 7 7 - 8 8 - 9 9 - 11 ½

Preventive line Knee-high stocking for men/women

LUI & LEI

COMPRESSION CLASS

REF. 14 mmHg

18 mmHg

25 mmHg ARTICLE COLOURS

61090 63090Knee-high stocking (AD)

461561856862

61088 63088Knee-high stocking (AD)

461561856862

ST088Knee-high stocking (AD), silk

561856

65088Knee-high stocking (AD)

561856862

CONTENTIONMEDICALE


A


55

Characteristics

Stylish, high breathability men’s and women’s line available in 4 sizes with 3 different ankle pressures, with or without cotton in contact with the skin. ASQUAL certified. Available in several colours.

Indications

10 - 15 mmHg15 - 20 mmHg20 - 36 mmHg Prevention of oedema due to prolonged standing, prevention of traveller’s thrombosis, symptomatic treatment of early-stage venous insufficiency.

Contraindications

Acute dermohypodermitis, skin infections, advanced-stage obliterant arteriopathy, oedema of non-venous origin, known contact allergy to elastic support appliances.

Duration of treatment

Compression therapy with VARISAN® elastic compression stockings should only be performed during the daytime. The stocking should be put on in the morning, before getting up, if possible, and removed in the evening before going to bed.During rest, the compression exerted could prove to be excessive.For short afternoon rests there is no need to remove the stocking.We recommend as much walking as possible during the daytime.


LUI & LEI

Colours

461 maroon

561 blue

856 grey

862 black

CONTENTIONMEDICALE


A



I 10 - 15II 15 - 20III 20 - 36

56

40 den

SizeWeight kg

4042

4345

4648

4951

5254

5557

5860

6163

6466

6769

7072

7375

7678

7981

8290

Hei

ght

cm

< 150150-152153-155156-158159-161162-164165-167168-170171-173174-176177-179

> 180

1 2 3 4 5

COMPRESSION CLASS

REF. 6 mmHg ARTICLE SIZE COLOUR

14040 Knee high (AD)smooth knitting 1/2 - 3/4

100300862

14049 Stay up stocking (AG) smooth knitting 1/2 - 3 - 4

100300862

14015 Tights (AT) elegant smooth knitting 1 - 2 - 3 - 4

100300500862

14035 Tights (AT) smoot knitting 1 - 2 - 3 - 4 - 5

100200300500700862

6 mmHg

detail Art. 14049

Art. 14049Art. 14040

Preventive line relaxing stocking

57

40 den

CharacteristicsViva Stockings performs a continous micro-massage on the foot, from the ankle to the thigh, decreasing from bottom to top. Viva Stockings ease heaviness, swelling and tiredness.

Indications

6 mmHgPrevention of minor syntoms of venous insufficiency, as fatique and heavy legs.

Contraindications

Severe dermo hypodedrmitis, cutaneous infection, allergy from tissues.

Colours

100 light

200 natural

300 beige

500 cocoa

700 smoky

862 black

6 mmHg

Compression

Art. 14035Art. 14015

foot detail

58

Preventive line Relaxing stockings

70 den

SizeWeight kg

4042

4345

4648

4951

5254

5557

5860

6163

6466

6769

7072

7375

7678

7981

8290

Hei

ght

cm

< 150150-152153-155156-158159-161162-164165-167168-170171-173174-176177-179

> 180

1 2 3 4 5

12 mmHg

detail Art. 14076 Art. 14072

Art. 14R79

COMPRESSION CLASS


14070 Knee high (AD)mesh jersey 1/2 - 3/4

100200300862

14079 Stay up (AG) smooth jersey 1/2 - 3 - 4

100200862

14R79 Stay up (AG)mesh jersey 1/2 - 3 - 4 - 5

100300862

14071 Thigh high (AG)mesh jersey 2 - 3 - 4 - 5

100200300862

14025 Elegant tights (AT)smooth jersey 1 - 2 - 3 - 4

100300600862

14072 Tights (AT)mesh jersey 1 - 2 - 3 - 4 - 5

100200300400500700862

14076 Super gradvated tights (AT) 2 - 3 - 4

100200300862

59


Indications

12 mmHgPrevention of minor syntoms of venous insufficiency as swelling of ankles and foot, and also indicate to prevent cellulitis.

Contraindications


Colours

100 light

200 natural

300 beige

400 nut brown

500 cocoa

600 moka

700 smoky

862 black

70 den

12 mmHg

Art. 14076 Art. 14071

Art. 14071

Art. 14070

Compression

60

Preventive line Relaxing stockings

SizeWeight kg

4042

4345

4648

4951

5254

5557

5860

6163

6466

6769

7072

7375

7678

7981

8290

Hei

ght

cm

< 150150-152153-155156-158159-161162-164165-167168-170171-173174-176177-179

> 180

1 2 3 4 5

140 den

18 mmHg

Art. 14149 detail Art. 14149

Art. 14140

COMPRESSION CLASS


punta chiusa

14140 Knee high (AD)mesh jersey 1/2 - 3/4

100200300862

punta aperta

14A40 Knee high (AD)mesh jersey 1/2 - 3/4 100

14149 Stay up (AG)mesh jersey 1/2 - 3 - 4

100200300862

14142 Tights (AT)mesh jersey 1 - 2 - 3 - 4 - 5

100200300500700862

14146 Super gradvated tights (AT) 2 - 3 - 4

100862

61


Indications

18 mmHgPrevention of minor syntoms of venous insufficiency, for those who are standing a lot.

Contraindications


Colours

100 light

200 natural

300 beige

500 cocoa

700 smoky

862 black

140 den

18 mmHg

Art. 14142Art. 14142

foot detail

Compression

62

63

Diabetic LineDue to the progress made in the treatment of diabetes, the biggest problem of diabetic patients is no longer that of survival but that of chronic complications; for example, arteriopathy of the lower limbs.

In fact, diabetic foot is becoming an increasingly major complication of diabetes.

The larger number of hospital stays is due to this complication and, according to WHO statistics, 15% of diabetic patients will suffer an ulcer of the foot requiring medical treatment at some time in their lives.

64

Rationale for using preventive stockings in diabeticsThe complications of both early-onset (at a young age) and late-onset (at an older age) of diabetes mellitus, arteriopathy and neuropathy particularly affect the legs and feet.

Vascular disease concerns both the microcirculation and the macrocirculation, appears earlier than arterosclerotic vascular damage in non-diabetic patients and tends to affect the distal, tibioperoneal vessels more than the proximal, femoropopliteal vessels.Neuropathy is expressed by progressive damage that eventually leads to the loss of pain sensitivity.

The two conditions may be present independently of one another or coexist in the same patient.

1 2

HIGH GI

LOW GI

TIME / HOURS

BLOO

D GL

UCOS

E LE

VELS

65

Diabetic foot is the most striking expression of vascular and neurosensory damage and presents the risk of skin lesions due both to ischemia and the lack of sensitivity to pain, which exposes the patient to a degeneration of the skin lesion because there is no pain and therefore the patient is unaware of the damage.

The ischemia and damage caused to the skin, which is dry and hypotrophic, also results in microlesions that can expose diabetic patients to particularly dangerous infections due to their predisposition for these complications and the risk of colonization of deep and bone tissues.

Vascular and neurological damage can be prevented or repaired in time through effective handling of the disease from a metabolic point of view.

At an early stage of damage, patients can wear shoes specially designed to avoid excessive pressure on the osteomuscular system and skin to prevent or cure ulcers.

Cleansing and taking care of the skin and the early treatment of skin damage prevent the local and systemic spread of infections.

Art. CRM88

66

Size 1 2 3 4

Foot 35 - 37 38 - 40 41 - 43 44 - 46

Size 3½ - 5 6 - 7½ 8 - 9 10½ -12½

Sock for diabetics and sensitive feet

DIABETIC

REF. CODE ARTICLE COLOURS

CRC88 VARISAN diabetic 504

CRM88 VARISAN diabetic with toe separation

161504

Art. CRM88 Art. CRM88

67

Characteristics

Innovative sock with no compression and no elastic on the upper hem.The VARISAN sock is made using a special yarn called CRABYON, with the following characteristics:Anti-bacterial, Anallergic, Antistatic, Antiodour, High breathability.

Indications

Sock for people with Diabetes, Arthritis, Athlete’s foot, sensitive and delicate feet. Hyperglycaemia may cause the capillaries to close at their extremities and a gradual decrease in the sensitivity of the feet. Those who feel no pain suffer cuts and ulcers more easily and do not realise immediately. Diabetic patients must therefore take special care of their feet. VARISAN DIABETIC is a sock specially designed for prevention, reducing the risk of foot lesions in diabetic patients and is sufficiently soft and adaptable to the shape of the leg.

DIABETIC

Colours

161 white

504 navy

Art. CRC88

Art. CRC88

68

69

Maternity LinePregnancy is a an extremely important biological event.

Weight gain increases the risk of venous insufficiency in the legs. The pump in the diaphragm-abdomen works less efficiently due to stretching of the abdomen by the foetus.

Under these conditions, the complex abdominal muscle system made up of the external oblique muscle, internal oblique muscle, rectal and transverse muscles, is also subjected to severe stress.

Certain precautions must therefore be taken, such as the use of preventive stockings, maternity belts and support bras.

During the post-natal period, we recommend muscle support products, which are a must for keeping one’s figure, correct posture and muscle tone.

70

Why pregnancy aggravates or can cause venous diseasesDuring pregnancy, venous diseases occur more frequently; the onset of varicose veins is an extremely frequent event: in its mildest forms (telangectasias and slight vein dilation), this disease occurs in 70-75% of cases.

Varices appear during pregnancy in women with a predisposition for them: pregnancy acts as a trigger or accelerator of a problem already present but not yet evident.

71

Pregnancy therefore has a considerable influence on the natural progress of venous disease as it can determine the onset of new diseases and reveal a state of venous insufficiency not yet clinically evident; in many cases, a spontaneous regression occurs during the first few months after childbirth.

Hormonal changes (increase in oestrogen and progesterone) and the increase in volume of the uterus causes stasis in the veins of the pelvis and legs already from the first few weeks of pregnancy.

Widespread dilations may occur during pregnancy both in the principal venous trunks (saphenous veins), and at other less common sites.

The onset of varicose veins in relation to the periods of pregnancy presents the following statistical trend:

• 70% in first trimester

• 25% in second trimester

• 5% in third trimester.

72

In short, pregnancy causes modifications to both the quantity and the quality of circulation in women, that may bring to light a venous disease latent up to that moment.

Pregnancy may physiologically cause:

• Increase in volume of bloodThe volume of blood increases right from the start of pregnancy, altogether by 20%.It is for this reason that the stasis in the legs also increases while standing.Women with insufficient venous return suffer venous injury as early as the first few months of pregnancy.

• Reduction in vascular tone caused by the hormones of pregnancy (dilation of vessels following the reduction in tension of the vascular part) The hormones that a woman’s body spreads to protect her pregnancy perform many functions that include keeping the uterine muscles relaxed prior to childbirth and also keeping the muscles of the blood vessels relaxed.

Venous capacity increases considerably (veins and, in particular, the deep veins, swell enormously) and the speed of the blood inside the excessively full veins decreases. This is a further cause of the problems typical of pregnancy because it creates heaviness and tension of the legs, an “electric shock” feeling, pins and needles and swollen feet.It can also form the base for triggering deep vein thrombosis at the end of pregnancy.

• Increase in pressure in the legs both when standing and when lying down caused by the pressure exerted on the veins of the pelvis by the growing child.

This increase is present at the start, above all while standing, but during the second half of pregnancy also when lying down due to the weight of the child on the venous structures of the pelvis. This slowing down of venous return from the peripheral area to the heart further aggravates the swelling of the superficial and deep veins.

• Increase in blood clotting capacityThe normal composition of the blood is modified in order to protect the fetus during pregnancy. Under conditions of an extremely slow venous return, however, this modification may cause thrombosis of the superficial veins or deep veins close to childbirth.

73

The use of compression stockings during pregnancy is not just important from prophylactic and cosmetic points of view in order to prevent the onset of varices and their complications, but also on a more general level, in order to obtain a positive, beneficial effect on a pregnant woman’s whole body.

When the woman is standing, her own blood flow and the uteroplacentar and fetal blood flow may deteriorate: it can be said that the improvement to the woman’s entire circulation by elastic compression stockings also significantly improves the heart rate of the fetus.

As an upright position and especially the need to remain standing is almost always unavoidable by pregnant women, and as the negative effects can have an impact not only on the mother, but also on the fetus, it follows that this disorder should not only be treated but also prevented.

It is therefore important to wear elastic stockings all the time.

Precautions

Art. 623GN

74

At this point, it is worth digressing slightly to point out that elastic stockings purchased by individuals are often not the most appropriate: attracted by advertisements of “comfortable” or “preventive” elastic compression stockings, many women purchase products that are unable to eliminate the symptoms suffered or, more often, insufficient to correctly cure the underlying venous disease (presence of widespread or sparse varicose veins, swollen legs in the evening, itching of the ankles).

To all effects and purposes, the elastic compression stocking is a medical device, that is, therapeutic; the pressure that the product exerts on the ankle must therefore be suited to the necessary degree of prevention of the woman’s disease.

“Preventive stockings” are to be considered NON-therapeutic; they start from a pressure of 6 or 12 mmHg (on average 40 or 70 Den) and reach a pressure of 18 mmHg (which corresponds to 140 Den) and are indicated in the early months for women with no venous disease.

Ccl. 1 compression stockings, on the other hand, are therapeutic and apply a pressure of 18/21 mmHg at the ankle; these stockings are prescribed after the first 5 months of pregnancy.

Art. 66129

75

The elastic compression stocking to be worn by pregnant women with no varices and less than 5 months pregnant is the one defined “relaxing”, i.e. 18 mmHg.

Starting from the 5th month, the elastic compression stocking should be Ccl. 1 while, for a pregnant woman with varices or a diagnosis of deep vein insufficiency, the stocking to be worn in the first 5 months of pregnancy will be a Ccl. 1 followed by a Ccl. 2 stocking after the 5th month.

For these patients there is no point in wearing “relaxing” stockings during the first few months of pregnancy as this compression class does not improve venous return to the heart at all.

In order to choose the right stocking for a pregnant woman with venous disease, a Doppler US scan of the legs can be performed and the venous pressure measured in the standing and lying positions; this examination is used to determine the right pressure to be applied to the affected vein or veins in a quick and non-invasive manner.

Which stocking should be used for venous circulation

TYPE Of STOCKING

PATIENT WITH VARICES

PATIENT WITH NO VARICES

Relaxing stockings No From the start to the 5th month

Ccl. 1 therapeutic stockings

From the start to the 5th month

After the 5th month

Ccl. 2 therapeutic stockings

After the 5th month No

The following table summarizes the most common indications for compression therapy during pregnancy:

Art. 623GN

76

CIRCUMFERENCE (cm)


Thigh 50-55 53-58 53-58 56-61 56-61 60-66 60-66 64-70 64-70 70-77

Calf 31-34 34-37 34-37 37-40 37-40 40-44 40-44 44-48 44-48 48-52

Ankle 19-20 19-20 21-23 21-23 23-25 23-25 25-27 25-27 28-30 28-30

LENGTH (cm)

Short NormalStocking 66 - 73 74 - 82

COMPRESSION CLASS


Closed toe

623GE Maternity tights (ATU), short

623GN Maternity tights (ATU), normal

Maternity Line Medical compression stockings

TOP

B

C

G

G

D

A

GÜTEZEICHEN

MEDIZINISCHE

KOMPRESSIONS-

STRÜMPFE

RAL

Art. 623GE detail of Art. 623GE

77



I 18 - 21

CharacteristicsThe VARISAN® TOP line is RAL certified and available in 5 sizes and 2 lengths.The product is very comfortable as it is made of a multifilament yarn, which makes the stocking soft, easier to put on and allows it to breathe.Many products are available with cotton in contact with the skin.All the articles in this line can also be made to measure.

IndicationsVarices, varices during and after pregnancy, initial venous oedema, reticular veins.

Contraindications


Duration of treatmentCompression therapy with VARISAN® elastic compression stocking should only be given during the daytime. The stocking is to be put on in the morning, if possible before getting up and taken off in the evening, before going to bed.During rest, the compression exerted could prove to be excessive.For short afternoon rests there is no need to remove the stocking.We recommend as much walking as possible during the daytime.


TOP

739 beige

Colours

GÜTEZEICHEN

MEDIZINISCHE

KOMPRESSIONS-

STRÜMPFE

RAL

Art. 623GE Art. 623GN

Detail of foot

78

CIRCUMFERENCE (cm)

Size 1 2 3 4

Thigh 50 - 56 53 - 59 56 - 62 59 - 65

Calf 29 - 32 32 - 36 36 - 40 40 - 44

Ankle 18 - 20 20 - 23 23 - 26 26 - 29

Maternity Line Medical compression stockings

SOFT

COMPRESSION CLASS

REF. 10 - 15mmHg

15 - 20mmHg ARTICLE COLOURS

Closed toe

MF341 Maternity tights (ATU)closed toe

750862

MF441 Maternity tights (ATU)closed toe

120862

B

C

G

G

D

A

CONTENTIONMEDICALE


A

79



I 10 - 15II 15 - 20

CharacteristicsThe VARISAN® SOFT line is ASQUAL certified and available in 4 sizes and 1 length.The product is very pleasing to the touch and the eye and is available in several colours.

IndicationsMild functional symptoms of venous insufficiency, reticular veins, ectasia.

Contraindications


Duration of treatmentCompression therapy with VARISAN® elastic compression stocking should only be given during the daytime. The stocking is to be put on in the morning, if possible before getting up and taken off in the evening, before going to bed.During rest, the compression exerted could prove to be excessive.For short afternoon rests there is no need to remove the stocking.We recommend as much walking as possible during the daytime.


SOFT

Colours

120 pink beige

750 fawn

862 black

CONTENTIONMEDICALE


A

detail of foot

Art. MF341

80

CIZETA MEDICALI S.p.A. - Via IV Novembre, 46 - 20012 Cuggiono (MI) Italy

Tel. 02.97.21.81.1 - Fax 02.97.24.07.34

www.cizetamedicali.com - [email protected] code and VAT no. 06626330150

800791466Numero Verde

free phone number

Customer serviceMonday-Friday 8.30-12.3013.30-17.30

Printing completed in May 2013

Documents

A History of Quality - Kayra Medical · borne in mind that legs are easily compressible as they are made up of tissues that are actually elastic themselves and so the external compressive