Compression Therapy

WoundSource Editors's picture

Compression therapy is a well-established treatment modality for a number of conditions, including venous disorders, thrombosis, lymphedema, and lipedema. It is also very effective in treating various kinds of edema.1 Based on patient diagnostic data, many patients with these conditions can benefit from targeted compression therapy.

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WoundCon Faculty's picture

By: Karen Bauer, NP-C, CWS

How often should ankle-brachial indexes (ABIs) be repeated? If someone has a stage 3 pressure injury to the top of the foot, should compression be held on that extremity?

The Wound, Ostomy and Continence Nursing Society guidelines suggest ABIs every 3 months routinely, while the Society for Vascular Surgery guidelines recommend that post endovascular repair, ABIs are done at 6 and 12 months (then yearly). For open revascularization, surveillance studies can be at 3, 6, and 12 months. Ultimately, many factors play into this. If the ulcer is closing and the limb remains stable, you might forgo frequent ABIs, but if the ulcer is not closing, or the patient has new or persistent ischemic symptoms, you should check ABIs more frequently. As far as compression with a dorsal foot pressure injury is concerned, as long as arterial status has been ascertained, compression can be utilized. The original source of pressure should be removed (shoe? ankle-foot orthotic?). If there is a venous component, cautious compression will aid in ulcer resolution.

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WoundCon Faculty's picture

By: Marta Ostler, PT, CWS, CLT, DAPWCA, and Janet Wolfson, PT, CLWT, CWS, CLT-LANA

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WoundSource Practice Accelerator's picture

By the WoundSource Editors

Lower extremity wounds such as diabetic foot ulcers (DFUs), venous ulcers, and arterial ulcers have been linked to poor patient outcomes, such as patient mortality and recurrence of the wound. Although precise recurrence rates can be difficult to determine and can vary across different patient populations, we do know that the recurrence rates of lower extremity wounds are quite high.

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By the WoundSource Editors

Venous ulcers are known to be complex and costly. There is an array of evidence-based treatment options available to help formulate a comprehensive treatment plan toward wound closure. Health care professionals should utilize treatment options while encompassing a holistic approach to venous ulcer management. Involving the patient and/or caregiver in developing a treatment plan will increase the chances of successful wound healing outcomes. Wound closure is the primary goal of a treatment plan; however, preventing recurrence and infection should be considered just as important.

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WoundSource Editors's picture
Edema

By the WoundSource Editors

Edema is the abnormalaccumulation of excess fluid within tissue. The swelling associated with edema can be localized to a small area following an acute injury, it can affect an entire limb or a specific organ, or it can be generalized throughout the entire body. Edema is not a disease, but rather a symptom that can indicate general health status, side effects of medications, or serious underlying medical conditions.

Janet Wolfson's picture
Frequently Asked Questions

By Janet Wolfson, PT, CLWT, CWS, CLT-LANA

Reflecting back on "In the Trenches With Lymphedema," WoundSource's June Practice Accelerator webinar, many people sent in questions. I have addressed some regarding compression use here.

Alton R. Johnson Jr.'s picture
Compression therapy for wound management

By Alton R. Johnson Jr, DPM

Four weeks ago, I was granted the privilege to treat a patient with type 2 diabetes with neuropathy who presented to the wound care center after developing a full-thickness pressure ulceration on the lateral aspect of her right leg as a result of an ill-fitted brace used four weeks earlier. The first clinical feature I noticed about the patient's lower extremity compared with the previous encounter was marked increased pitting edema. As a sequela of the lack of compression, the patient's lower extremity edema had increased, causing the wound to break down further in comparison with our last encounter with her. I first asked the patient why she discontinued the multipurpose tubular bandage that was dispensed and applied to her right extremity during the last visit. Her immediate response was that the home health aide had disposed of it by mistake; however, the patient stated that the aide used an available non-compressive stockinette instead.

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Velcro devices for Venous Ulcers

Temple University School of Podiatric Medicine Journal Review Club
Editor's note: This post is part of the Temple University School of Podiatric Medicine (TUSPM) journal review club blog series. In each blog post, a TUSPM student will review a journal article relevant to wound management and related topics and provide their evaluation of the clinical research therein.

Article Title: Review of Adjustable Velcro Wrap Devices for Venous Ulceration
Authors: Stather PW, Petty C, Howar AQ
Journal: Int Wound J. 2019 Mar 21 [Epub ahead of print].
Reviewed by: Olivia Hammond, class of 2020, Temple University School of Podiatric Medicine

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Karen Bauer's picture
Venous Leg Ulcer

by Karen Bauer , NP-C, CWS

In my recent WoundSource webinar on management strategies of venous leg ulcers (VLU), I discussed the complex pathophysiology of VLUs and procedural interventions that can help them reach closure.

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