Edema treatment with compression

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The purpose of compression therapy is to enhance the functioning of the muscle pump in calf and thus improve the return of blood flow towards the heart. In addition, compression therapy reduces fluid leakage into tissues and forces fluids from the tissues back to the veins and lymphatic system, resulting in decreased edema.

In edema treatment the pressure is generated so that it gives a gradual compression. The strongest support is in the extremities, gradually decreasing towards the midsection. These garments are called medical compression garments. Compression treatment is the removal or prevention of edema with the use of these garments. Compression treatment can be implemented in every compression class from A to IV. Compression garments support the natural lymphatic circulation of the body and are used during the day. Compression therapy requires a strong commitment to care. There are no contraindications in using compression garments during the night or when at rest.

Compression treatment is needed when the person has venous insufficiency, lymphatic edema, venous ulcers, swelling caused by injuries or operations. Swelling is caused by the intercellular accumulated fluid. The reason might be insufficiencies in the lymphatic system or surface veins or tissue damage.

Venous insufficiency causing swelling of the feet is generated by the slowed blood flow back from the lower extremities whilst venous pressure climbs higher causing fluids to seep through from capillary veins to the tissues. Swelling arises when the capacity of the lymphatic system cannot remove the accumulated fluid. The most common signs of venous insufficiency are varicose veins which every third of the women have. Venous insufficiency can develop without visible changes or the swelling is present only at evenings.

Preventive measures are recommended to those with stagnant lifestyles (lots of sitting or standing), when travelling, during pregnancies and in the aftercare of operations. The onset of symptoms of congenital illnesses can be significantly delayed by preventive compression therapy.

In advanced venous insufficiency the tissue metabolism weakens and causes, in addition to varicose veins, skin lacerations, changes and inflammation. This damages the lymphatic system and swelling becomes permanent and even ulcers might appear. Prevention of swelling is recommended to people doing a lot of sitting, standing or traveling (trains, airplanes and cars). Prevention is crucial also during pregnancy and after surgeries. Symptoms caused by genetic factors can be delayed considerably with preventive care.

Compression garments are used all the time, during daytime. Compression treatment requires dedication. There are no contraindications in using compression garments when at rest or during night-time. However the garment can be removed or a garment with less compression can be acquired for night-time, if the compression feels uncomfortable.

Goals of compression (edema) treatment:
• Prevention
• Removal of excess fluids from the system
• Decreasing inflammation, pain management

Lymed Compression products are primarily custom-made products. The compression class is chosen by the persons responsible for the compression treatment.

CCL A: Prevention (10-14 mmHg)

– Predisposed persons
– Swollen legs, mild oedema
– Telangiectasia

CCL I: Mild (15-21 mmHg)

– Varicose veins
– Acrocyanosis
– Post-sclerotherapy or -telangiectasias
– Truncal varicose veins
– Varicose veins with substantial oedema
– Post-varicectomy and -sclerotherapy
– Arthrosis of the foot and knee

CCL II: Moderate (23-32 mmHg)

– Post-thrombotic syndrome
– During treatment of ulcers
– Post-trauma treatment
– Angiodysplasias
– Deep venous thrombosis & insufficiency
– Reversible lymphoedema
– Lipoedema

CCL III: Strong (34-46 mmHg)

– Severe oedema
– Chronic hypodermitis
– Irreversible lymphoedema

CCL IV: Very strong (>49 mmHg)

For all the pathologies already listed and present in their most severe form.

 

Sources: (Lymed, Brijesh Nair Indian Dermatol Online J. 2014 Jul-Sep; 5(3): 378–382., Suomen Haavanhoitoyhdistys https://shhy.fi/site/assets/files/1041/potilashoito-ohje.pdf)