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Principles of wound care
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Compression bandaging should be first-line treatment to optimise treatment for people with venous leg ulcers, chronic venous insufficiency and oedema (Wounds UK 2016). Treatment of venous disease is aimed at correcting, as far as possible, incompetent values. Compression therapy supports the veins and valves to push the venous blood up the leg towards the heart, reducing congestion in the capillaries and veins. At the same time, the extra fluid from the tissue is squeezed back into the veins, reducing oedema. The increased blood velocity ensures that more nutrients reach the tissues to improve the skin condition, reduce dryness and restore elasticity. The compression is applied so that the pressure at the ankle is higher than the pressure at the knee, that is, graduated according to Laplace’s law. There are many different types of compression therapy (see Table 13.8).
Compression therapy: Optimal pressure? Bandage versus stocking
Published in Byung-Boong Lee, Peter Gloviczki, Francine Blei, Jovan N. Markovic, Vascular Malformations, 2019
Isabel Forner-Cordero, Jean-Paul Belgrado
Although the pathophysiology of edema varies, static and dynamic compression are the cornerstone of lymphedema management. However, the evidence base for the optimal application, duration, and intensity of compression therapy is lacking.1, 2 Different scientific groups have tried to summarize the recommendations for prescribing compression.3, 4
Deep Venous Thrombosis
Published in Stephen M. Cohn, Matthew O. Dolich, Kenji Inaba, Acute Care Surgery and Trauma, 2016
Casey J. Allen, Evan J. Valle, Shevonne S. Satahoo, Enrique Ginzburg
There have been historical data supporting the use of compression stockings to reduce the incidence of postthrombotic syndrome. A Cochrane review in 2004 included three randomized controlled trials to evaluate the role of compression therapy versus no intervention [43]. At 2 years, compression therapy was associated with a significantly decreased incidence of postthrombotic syndrome (OR, 0.31, 95% CI 0.20–0.48). In regard to severe postthrombotic syndrome, the OR was 0.39 (95% CI 0.20–0.76). There was also reduction in regard to swelling, pain, and clinical scores observed in those undergoing compression therapy (p < 0.05), with no serious adverse events.
The effectiveness of exercise training in treating venous thromboembolism: a systematic review
Published in The Physician and Sportsmedicine, 2021
Lin Xu, Chenying Fu, Qing Zhang, Chengqi He, Quan Wei
The best treatment option for VTE has been widely studied among researchers, and pharmacological treatment and surgical methods are commonly recommended for such patients according to disease severity [7]. Compression therapy and exercise training are common nonpharmacological and noninvasive treatment methods. Compression therapy is commonly used for all DVT patients because it reduces tissue swelling and enhances calf muscle contractility [8]. However, exercise training is rarely used clinically because it conflicts with more intense aftercare in patients with VTE. Some studies have explored the role of exercise training in survivors with VTE. Evidence-based clinical practice guidelines from the American College of Chest Physicians suggest early ambulation over initial bed rest for patients with acute DVT of the leg [9]. In addition, a few guidelines and consensus documents have suggested that exercise rehabilitation is necessary and safe for acute DVT patients with or without PE after therapeutic anticoagulation is achieved or if compression therapy is received at the same time [7,8,10]. However, these guidelines are vague about the introduction of exercise prescriptions and lack detailed information; thus, exercise training implementation clinically remains low, and no published, high-level evidence to date supports its application in VTE survivors.
Faecal impaction causing bilateral pelvic venous thrombosis
Published in Acta Chirurgica Belgica, 2018
Maxime Dewulf, Yves Blomme, Cedric Coucke
Compression therapy remains the golden standard in case of post-thrombotic chronic venous insufficiency [10]. However, there is growing evidence that endovascular treatment provides a clear benefit in patients with iliocaval obstruction who have severe symptoms of post-thrombotic syndrome (PTS) despite adequate compression therapy [9,10]. Rather surprisingly, there was a full venous recanalisation after three months. As duplex ultrasound showed no evidence for residual iliocaval venous obstruction, and our patient only had mild symptoms remaining after six months of treatment, a further endovascular treatment was not proposed.
Manual lymphatic drainage with infantile klippel-trenaunay syndrome: Case report and literature review
Published in Cogent Medicine, 2018
Because of the diseases’ rarity only scarce evidence is available of how to treat KTS. Most studies are case reports (de Leon, Braun Filho, Ferrari, Guidolin, & Maffessoni, 2010, Mneimneh, Tabaja, & Klippel-Trenaunay, 2015). Debate continues about the best strategies for the management of KTS. Currently recommended management involves symptomatic compression therapy (CT) (Jacob et al., 1998; KTS Working Group, Vascular Anomalies Center, 2016) and interventional methods, such as vein sclerosis (Noel et al., 2000). Sclerotherapy is not carried out in small infants (Leung, Leung, & Fung et al., 2014; Nakahata et al., 2016), and higher patient numbers would be required (Nitecki & Bass, 2007). Sclerotherapy should be performed with ultrasonographic and fluoroscopic guidance, but is normally a safe procedure. Proposed agents are sodium tetradecryl sulphate or ethanolamine (Leung et al., 2014; Nakahata et al., 2016). Possible side effects are bruises or inflammation, compression is required afterwards (Worthington-Kirsch, 2005). Billington et al. refer to failed surgical interventions (Billington, Shah, Elston, & Payne, 2013), which underlines the need for evidence for conservative techniques. In 2010 Liu et al. (Liu, Lu, & Yan, 2010) published a paper in which they described common lymphatic disorders in KTS and highlighted the need for more academic research in the field of lymphatic system dysplasia with KTS. McRae et al. have shown that a multidisciplinary approach including dermatology, diagnostic- and interventional radiology, haematology, paediatric surgery, physiotherapy and social services should be considered (McRae, Adams, & Pereira et al., 2013). The KTS Working Group advocated an early treatment approach (KTS Working Group, Vascular Anomalies Center, 2016), as did Billington et al., who also recommended a multi-treatment plan (Billington et al., 2013).