Compression

• Compression therapy increases skin perfusion pressure and decreases interstitial fluid volume, thereby increasing tissue oxygenation, thus promoting tissue healing.
• Tensor bandages and post-operative anti-embolic stockings, e.g.,TEDS™, do not provide therapeutic compression for treatment and management of venous stasis disease.
• Compression systems must be applied correctly so that sufficient (but not excessive) pressure is applied.
• Recognition of significant arterial insufficiency is important.
• No healing will occur in the presence of severe occlusive arterial disease of the affected limb.
• External compression using various forms of pneumatic compression pumps (PCPs) are indicated for individuals with chronic venous insufficiency.
• Findings from several studies indicate that high compression bandaging should be used for venous leg ulceration, as per La Place’s Law.

P = 4630 x N x T

        C x W

P = sub-bandage pressure (mmHg)

N = number of layers

T = tension within bandage (Kgforce)

C = limb circumference (cm)

W = width of bandage (cm)

• Graduated compression hosiery should be prescribed for life.
• Provided the client has been measured by a certified stocking fitter for the correct size, elasticized stockings are a safe alternative to bandages.
• When edema and exudate are controlled, the use of therapeutic compression stockings may be considered.
• The client should be prescribed regular vascular exercise by means of intensive controlled walking and exercises to improve the function of the upper ankle joint and calf muscle pump.
• Exercise is necessary to enhance compression therapy.
• When resting, elevation of the limb above chest level is beneficial.