Understanding compression therapy
Vascular diseases are the most common problem leading to skin ulcerations on the lower leg. venous Leg Ulcers (VLUs) are the last stage of chronic venous insufficiency and occur as a result of circulatory problems in the veins due to increased venous pressure.
When to apply a compression therapy?
In venous leg ulcer management, compression increases ulcer healing rates compared with no compression⁽¹⁾.
Strong compression therapy (minimum of 40mmHG) may be safely applied to a patient presenting with a wound on the lower leg with an ABPI (ankle Brachial Pulse Index) greater than 0.8. This type of wound is defined as a Venous Leg Ulcer. Another indication for compression therapy is when oedema is present in the lower limb. Compression is seen to be effective management for oedema.
Patients presenting with a wound in the lower leg with an ABPI of < 0.8 may need to be referred to a specialist for a vascular assessment. In some clinical areas, treatment of mild compression (maximum of 20mmHg) may be introduced when an ABPI between 0.6 and 0.8 is present. These lower limb wounds are usually classified as mixed aetiology ulcers.
How compression therapy can cure Venous Leg Ulcers?
Compression is defined as the application of external compression to minimise or reverse the vascular and skin changes caused by Chronic venous insufficiency.
Applied externally to the lower leg, compression systems increase pressure on the skin and underlying structures to counteract the force of gravity.
A continuous compression of around 40mmHg at the ankle is the recommended treatment⁽²⁾ and allows:
- venous reflux reduction
- Improvement of the blood flow and venous return
- Lymphatic function to improve which reduces oedema
This treatment leads to effective healing of the ulcerated area. However, effective and consistent compression can be difficult to achieve on a daily basis, which can delay wound healing affecting the patient’s quality of life.
DID YOU KNOW? - Venous Leg Ulcer - VLU
Venous leg ulcers are the most common leg ulcer and make up about 50-60% of all leg ulcers. In general, venous leg ulcers tend to be shallow and irregular in shape, often occurring in the lower third of the leg (pre-tibial, anterior to medial malleolus⁽¹⁾).
- Franks , P., Barker,J., Collier, M. et al. Management of patients with venous leg ulcer: challengesand current best practice, J Wound Care, 25; 6, Suppl, 1–67
- O’Meara, S., Cullum, N,. Nelson, EA., Dumville, JC. Compression for venous leg ulcers. Cochrane Database of SystematicReviews. 2012; 1: CD000265.