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Compression therapy

Compression therapy for veins is the first and foremost method of care, designed to improve circulation in extremities. It is a type of a garment or stockings, made of elasticated fabric that gently applies pressure on the limb to strengthen vein function. It is a simple and effective means of increasing back flow of blood through veins and slowly works to stretch out the venous walls that helps eliminate swelling. The garment provides graded constriction gradually working its way up from the ankle to the leg and then the thighs. The purpose of the stocking is to replicate function of muscles by adding pressure to contracting areas. This allows the veins to transport blood and reduce pain in the limb.

Additionally, the effectiveness of any compression system is determined by the magnitude and duration of the compressive forces applied. The severity of blood flow constriction decides the amount of pressure the garment should provide. Therapeutic socks, stockings, pantyhose, wraps or sleeves are the different compression garments that can be used for indicative conditions. It can be carried out additionally to other treatments for venous and lymphatic diseases or as a stand-alone therapy for a lifetime. The aim of compression therapy is to improve venous function without compromising arterial function. The principal challenge with compression therapy is ensuring that the pressure provided is high enough to be effective, but not so high as to result in localized ischaemia and tissue damage.

Compression is involved in treating both venous diseases and lymphoedema. Most treatment regimens in common use for both conditions involve the application of pressure (compression) to force fluid from the tissue back into the circulatory system. Despite the differences in underlying aetiology, the basic principles and mechanisms relating to the application of compression in different conditions are the same. Sustained therapeutic compression therapy decreases lower leg venous hypertension by improving calf muscle pump efficiency, enhancing venous valve function and reducing oedema with very few side effects.

Some of the indications for compression therapy are:

  • Venous diseases with symptoms of the leg
  • Petal oedema
  • Varicose veins
  • Venous insufficiency leading to cosmetic skin changes
  • Prevention and treatment of Deep Vein Thrombosis
  • Superficial Thrombophlebitis
  • Active or healed venous leg ulcers
  • Lymphoedema
  • At risk for Oedematous conditions such as long-haul flights

Additionally, graduated compression therapy for veins has many positive effects on the body to both blood flow and the tissues themselves. Below are some of the physiological effects of compression:

Blood Flow Effects:

  • Increases venous blood flow
  • Decreases venous blood pooling
  • Decreases reflux in superficial and deep veins with diseased valves
  • Decreases pathologically high venous pressure

Effects on Tissue:

  • Brings down elevated swelling of the tissue
  • Increases drainage of toxic fluids
  • Decreases inflammation
  • Supports reparative processes
  • Serves as an agonist in the movement of tendons and joints

Compression therapy for veins can be carried out on a large proportion of patients with oedema of the lower extremities. The therapy should be adapted to co-occurring medical conditions, individual needs as well as personal abilities (dressing and undressing) in the context of providing patient-oriented care. Though, compression therapy may be contraindicated in certain cases such as advanced peripheral obstructive arterial disease, systemic arterial pressure < 80 mm Hg at the ankle, congestive cardiac failure, abscesses, Septic phlebitis, and chronic peripheral neuropathies.