Compression therapy

Compression therapy is one of the recognized methods of prevention and treatment of chronic venous insufficiency, lymphatic edema, venous thrombosis and pulmonary embolism. It involves creating external pressure that is transferred to blood vessels and tissues. For this purpose, he uses elastic bandages or special products with graduated pressure (tights, stockings and compression socks).

Compression therapy is only effective when it produces appropriate pressure. Depending on the severity of the disease, pressure ranging from 10 mm Hg to 50 mm Hg is used. The pressure is used to reduce the excess pressure inside the vein. You need to know that in a lying position, the pressure in the veins of the lower leg is low (about 10 millimeters of mercury), but after taking a standing position, the pressure increases up to 70 mmHg. Taking a step and activating the calf muscle pump pushes blood upwards and reduces the pressure in the veins to approximately 30 mmHg. This is the pressure value that the doctor wants to achieve when selecting therapeutic pressure on the foot and lower leg. Another important factor is the gradation of pressure, i.e. applying the strongest pressure decreasing towards the groin. Thanks to compression therapy, blood does not pool in the veins and lymph does not accumulate in the surrounding tissues. Improving the outflow of venous blood and lymph reduces swelling and the feeling of heavy legs, prevents the formation of varicose veins, venous thrombosis and pulmonary embolism. It is indicated in the initial stages of venous disease because it inhibits its development and reduces symptoms. In advanced forms of chronic venous insufficiency, it is an important treatment method to prevent its complications. Compression therapy is also recommended for people without clinical symptoms in the case of genetic predisposition, long-term standing or sitting work and long journeys (travel syndrome). Contraindications to the use of compression therapy are advanced arterial circulation disorders, inflammation of the skin and subcutaneous tissue in the acute phase, and massive fresh deep vein thrombosis.

There are hosiery products on sale whose task is to maintain the proper pressure despite the faulty functioning of the veins. This happens due to the pressure exerted on the legs from the outside. The pressure is different in every place thanks to the special, well-thought-out design of the product. It should be strongest around the ankles and gradually decrease towards the top. Each compression product is selected individually and precisely, so the leg circumference must be measured at different heights. At our Center, we teach patients how to properly measure their legs and select compression stockings that are appropriate for each patient. Wearing ill-fitting products, e.g. too tight below the knee or at thigh level, may nullify any benefits of compression therapy, as it will impede blood outflow and increase venous hypertension. At the beginning of venous insufficiency, products are used whose highest pressure on the legs around the ankles is approximately 20 mmHg, i.e. compression class I. For people with advanced venous insufficiency, much stronger products are produced - marked as compression class II or III. Sometimes it is necessary to use even class IV compression, i.e. over 40 mmHg.

Therapeutic compression stockings are effective when:

• They have properly, individually selected pressure and size,
• They are inserted when the veins are not excessively filled with blood (in the morning or after resting with legs raised)
• They are evenly stretched on the leg (very important - do not roll them up)
• They are replaced with new ones after the period recommended by the manufacturer (all products gradually stretch during use, and their pressure and effectiveness decrease)

These products may initially feel too tight. Our body, just like wearing glasses, simply has to get used to them. After about 2 weeks you will feel comfortable in them, swelling and fatigue will disappear. Good quality products maintain their effectiveness for several months. Well-fitting compression tights/stockings, despite the pressure exerted, must provide the patient with a feeling of comfort. If compression tights cause discomfort when worn or wrinkle, it means that they have not been fitted properly. In this case, they should be replaced.

In our center, we teach each patient how to properly measure the limb and select appropriate compression stockings. They are tailored to the patient's dimensions. A bit of elegance: now you can even order self-supporting stockings and choose colors and styles.

We provide services in the selection and sale of medical compression products from MEDI ( www.medi-polska.pl), which is the Polish branch of the German MEDI BAYERTOUCH concern.

Bandages are much cheaper and more readily available than hosiery. However, they are not very comfortable. Applying them properly is difficult. They can slip off your leg. They cause abrasions. However, in some situations they are very advisable, e.g. when there are wounds on the leg and you cannot wear knee-high socks, stockings or tights. Their action may also be more effective in severe states of venous insufficiency. Do not use plain white elastic bandages. Bandages recommended for vein diseases are characterized by low extensibility. They are produced in brown. Patients prefer this color because it is visible on the leg.

When bandaging the leg, the following rules should be followed:

• The bandage should be applied when the veins are not excessively filled with blood (preferably in the morning or in a lying position)
• The leg must be bandaged from the base of the toes to the knee or, if necessary, higher
• The leg is bandaged from the inside out, not the other way around,
• The pressure should be graduated so that it is strongest around the ankle
• You can finish putting on the bandage by gluing it to the calf with a special glue, which will effectively protect the bandage against cumbersome rolling;

When to use compression therapy:

• In people predisposed to varicose veins, working constantly in a standing or sitting position
• In people who experience symptoms of venous insufficiency, visible spider veins, swelling after a day's work
• In people with visible varicose veins, before and after each treatment
• In people with inflammation of superficial and/or deep veins during and after treatment
• In people with venous ulcers during and after ulcer healing
• Postthrombotic syndrome
• In people before and after vein surgery, as well as after vein obliteration
• In pregnant women, with varicose veins, when swelling increases

In the case of deep vein inflammation, compression therapy is recommended for up to two years from the onset of symptoms. For a person who does not suffer from venous diseases, but travels a lot, supportive knee-high socks are enough to prevent thrombosis while traveling. If you suffer from vein diseases, you should always wear compression class II anti-varicose tights or stockings when traveling.

When it is not recommended to use compression therapy:

• In people with advanced atherosclerosis confirmed by Doppler ultrasound
• In people with extreme circulatory failure of cardiac origin