Patients with swelling and chronic wounds or leg ulcers have access to a wide array of techniques to control fluid accumulation, including sophisticated compression pumps, wraps and garments. Chronic venous insufficiency is a prolonged condition in which one or more veins don't adequately return blood from the lower extremities back to the heart due to damaged venous valves. Symptoms include discoloration of the skin and ankles, swelling of the legs, and feelings of dull, aching pain, heaviness, or cramping in the extremities.

1. Using Compression
Therapy for Venous
Insufficiency
www.compressionpumps.com
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2. Types of Compression Therapy
 Multilayered elastic compression
wraps
 Elastic compression stockings
 Pneumatic compression devices
 Multilayer bandaging systems
 Low Elastic Medical Binders
 Nighttime Foam Compression
Garments
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3. Types of Compression Therapy
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4.  Compression therapy reduces blood
backflow in the veins and helps the
calf muscles propel blood back
toward the heart.
 Consistent compression therapy will
help heal and prevent future venous
ulcers and cellulitis
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5.  For ambulatory patients, a
multilayered elastic compression
wrap or multilayered bandage wrap
is best.
 Remember that compression
therapy can't be used in patients
who also have arterial insufficiency,
and can be used only with caution
in patients with mild arterial
disease. 4/17

6. Two-layer wraps
 provide 15 to 25 mm Hg of pressure
when a cohesive bandage is
applied.
 these may be best for a patient who
needs compression therapy but
can't tolerate higher pressures
because of discomfort.
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7. Four-layer elastic compression wrap
 increases the pressure to about 40 mm
Hg.
 first layer :absorbent padding bandage.
 second layer :light conforming bandage
 third layer :compression wrap applied
with the figure eight technique
 fourth layer :compression wrap, is
applied with a spiral technique.
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8. Compression Wraps & Ulcers
 If your patient has a venous ulcer,
you can apply a compression wrap
over the wound dressing. This
combination reduces ulcer pain and
encourages autolytic debridement
and wound healing.
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9. Applying a compression wrap 1
 choosing the compression method
 measure the patient's ankle
circumference
 If it's less than 18 cm (7.2 inches),
add additional cotton absorbent
padding or gauze before applying
the compression wrap.
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10. Applying a compression wrap 2
 For all patients, pad all bony
prominences, such as the tibial
spine and the malleolus.
 Measure ankle circumference
weekly—it should decrease as the
edema decreases.
 Have the patient dorsiflex her foot
and apply the compression wrap
according to the manufacturer's
directions.
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11. Helping your patient with therapy 1
 Because most compression wraps
are bulky, they can interfere with
the patient's ability to wear shoes.
Compression bandages also tend to
roll up at the toes when she tries to
put on shoes or slippers.
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12. Helping your patient with therapy 2
 A patient who's had a venous ulcer
will need lifelong compression
management
 After the wound has healed and leg
edema has decreased, measure and
size the patient for compression
stockings.
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13. Helping your patient with therapy 3
 These stockings are graded by the
pressure they provide: 20 to 60 mm
Hg at the ankle.
 The stockings come in various
lengths and styles. Some patients
may need custom compression
stockings—for example, if she has a
wide calf and a much smaller ankle.
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14. Helping your patient with therapy 4
 Deciding on the pressure grade for
stockings can be challenging.
 two-layer compression bandages ：
probably can tolerate 20 to 30 mm
Hg compression stockings.
 four-layer compression bandages ：
should be able to tolerate 30 to 40
mm Hg compression stockings.
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15. Helping your patient with therapy 5
 If the patient's ulcer recurs, check
that she's wearing the stocking
correctly and replacing it every 6
months. If so, she may need a
higher-pressure compression
stocking.
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16. Helping your patient with therapy 6
 The patient may find her
compression stockings difficult to
put on
 Suggest that she wear rubber
gloves to help her get a grip on the
stockings, but warn her not to pull
aggressively, which could rip them.
Lubricating silicone lotions applied
to the leg before donning stockings
may help to reduce friction.
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17. Helping your patient with therapy 7
 At the other end, compression stockings
can slip down at the top. A roll-on
adhesive designed for compression
stockings and applied to the leg can help
solve this problem.
 Advise the patient to buy new
compression stockings every 6 months
and have two pairs on hand so she can
wear one pair while the other is in the
laundry.
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18. Helping your patient with therapy 8
 Encourage patients to maintain a normal
body weight, exercise daily (a walking
program is especially good), and to
elevate their legs periodically throughout
the day. They shouldn't stand or sit for
long periods, wear constricting clothing
such as girdles, or cross their legs. Teach
them to protect their legs and feet from
injury and to inspect them daily. Remind
them that vigilant self-care can help avoid
another venous ulcer.
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