- 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.
Clinical Management
Assessment and Management of Venous Leg Ulcers
Point of Care Resources