Compression therapy

What is compression therapy?

Compression therapy with compression bandage or graduated compression stockings is an integral part of the management of varicose veins, gravitational eczema me venous leg ulcers both as an active treatment for ulcer healing and to prevent ulcer recurrence.

How does compression therapy help heal ulcers?

Compression therapy works by applying controlled pressure to surface veins, keeping their diameter small and forcing blood back into the deep venous system which in turn pushes blood uphill toward the heart. Improved blood flow helps heal active ulcers and prevent ulcer recurrences

Types of compression therapy.

There are several options for compression therapy. The two most commonly used methods are 3–4-layer compression bandage and elastic graduated compression stockings.

Compression bandage

Bandages with predetermined levels of compression are available; Light, moderate, high and extra high performance. The type of bandage used depends on the severity of the swelling and the amount of pressure that should be applied. For example, high-performance bandages are reserved for very large, swollen legs.

Compression bandages are useful if there are active ulcers, as once the wound is cleaned and dressed, the bandage can be easily wrapped around the leg from the toes to the calf. Elastic bandages provide graduated compression with the highest pressure on the ankle where it is needed most. The filler should be applied in strips over bony prominences to avoid excessive pressure.

Bandages may be left on or reapplied for several weeks until the swelling has subsided. Because of its elasticity as swelling goes down, the bandage maintains the right amount of pressure. When the ulcer has healed, compression hosiery may be recommended to provide a smaller but sufficient amount of pressure to maintain adequate blood circulation and prevent recurrences of the ulcer.

Compression socks

Compression stockings can be used as an alternative to a compression bandage for the treatment of active ulcers. It is also very useful in preventing ulcer recurrences. Compression stockings are classified according to the level of pressure applied to the ankle.

Measurements should be taken of the lower leg to ensure the stocking fits correctly. A properly fitted stocking will produce effective pressure graduation and will be comfortable to wear. An ill-fitting stocking can cause discomfort, trauma and more harm than good. In most cases, stockings are worn up to just below the knee, although thigh-high stockings are available if there is swelling above or below the knee or if there is a joint deformity.

Compression stockings are made from several different fibers including nylon, cotton yarn, and spandex. Standard stockings include circle knit stockings and flat knit stockings. Flatbed knit tights are more flexible than circular knit tights, making them easier to put on and take off. Net tights and one-way stretch tights are available as custom-made items.

Studies on compression stockings show that after stocking removal there is little evidence of reversal of the underlying disease process, such as improvement in calf muscle function or restoration of valves. Therefore, patients should be aware that graduated compression stockings, along with exercise, diet, limb elevation, and skin care, are part of the long-term management plan for venous insufficiency. and the leg ulceration.

Anti-embolism stockings

Anti-embolism stockings are not the same as support stockings or compression stockings. A popular type is the TED® stocking. Anti-embolism stockings have graduated compression to speed blood flow through the leg, but are designed to be worn when lying down rather than standing. They are used after the operation; The intention is to prevent embolism or blood clots.

Which are the contraindications to compression therapy?

Compression should not be used to arterial leg ulcers and should be used with caution in diabetic leg ulcers.