Facebook Instagram
Get a call

Compression Therapy

Indications

  • Venous leg ulcers (VLU)

  • Chronic venous insufficiency (CVI)

  • Edema (venous or lymphatic)

  • Lymphedema

  • Post–deep vein thrombosis (DVT) management (once cleared)

  • Varicose veins

  • Prevention of venous ulcer recurrence

Mechanism of Action

  • Reduces venous hypertension

  • Improves venous return to the heart

  • Decreases capillary leakage and edema

  • Enhances tissue oxygenation

  • Promotes wound healing

Types of Compression


1. Elastic Compression

  • Compression stockings

  • Elastic wraps

  • Provide sustained pressure at rest and during activity

2. Inelastic Compression

  • Unna boots

  • Short-stretch bandages

  • High working pressure, low resting pressure

3. Multilayer Compression Systems

  • 2-layer or 4-layer wraps

  • Gold standard for venous leg ulcers

  • Maintains consistent pressure (30–40 mmHg at the ankle)

4. Intermittent Pneumatic Compression (IPC)

  • Mechanical pumps

  • Adjunct therapy for refractory edema or immobile patients

Compression Levels (Stockings)

  • Mild: 8–15 mmHg (fatigue, mild swelling)

  • Moderate: 15–20 mmHg (varicose veins)

  • Firm: 20–30 mmHg (edema, post-ulcer healing)

  • Extra Firm: 30–40 mmHg (active venous ulcers, lymphedema)

Assessment Before Compression

  • Ankle-Brachial Index (ABI)

  • ≥ 0.8 → Full compression safe

  • 0.5–0.79 → Modified/light compression

  • < 0.5 → Compression contraindicated

  • Assess pulses, skin integrity, pain, neuropathy

  • Evaluate patient mobility and ability to apply garments

Contraindications

  • Severe peripheral arterial disease

  • Acute untreated DVT

  • Decompensated heart failure

  • Severe ischemic pain

  • Untreated infection with significant ischemia

Patient Education

  • Apply in the morning when swelling is minimal

  • Remove at night unless otherwise directed

  • Daily skin inspection

  • Elevate legs when resting

  • Replace stockings every 3–6 months

Clinical Pearls

  • Compression is essential for venous ulcer healing and recurrence prevention

  • Consistency is more important than compression type

  • Reassess ABI periodically, especially if pain or color changes occur

Scroll to Top