Compression therapy in mixed ulcers increases venous output and arterial perfusion

Mosti, Giovanni; Iabichella, Maria Letizia; Partsch, Hugo

doi:10.1016/j.jvs.2011.07.071

Cited by 159 publications

(174 citation statements)

References 34 publications

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“…in patients with mixed, arterial-venous leg ulcers. 19) In contrast to drug therapy compression treatment had never to pass any pharmacological phase I and phase II trials to confirm clinical efficacy and determine the therapeutic dose range. Although some insight concerning the mechanisms of action of compression has emerged from several studies during the last years, a lot more has to be learned in order to tailor and to optimize this important treatment modality to different clinical indications and to satisfy our patients.…”

Section: Mode Of Actionmentioning

confidence: 99%

Compression Therapy: Clinical and Experimental Evidence

Partsch

2012

Annals of Vascular Diseases

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Aim: A review is given on the different tools of compression therapy and their mode of action. Methods: Interface pressure and stiffness of compression devices, alone or in combination can be measured in vivo. Hemodynamic effects have been demonstrated by measuring venous volume and flow velocity using MRI, Duplex and radioisotopes, venous reflux and venous pumping function using plethysmography and phlebodynamometry. Oedema reduction can be measured by limb volumetry. Results: Compression stockings exerting a pressure of ~20 mmHg on the distal leg are able to increase venous blood flow velocity in the supine position and to prevent leg swelling after prolonged sitting and standing. In the upright position, an interface pressure of more than 50 mmHg is needed for intermittent occlusion of incompetent veins and for a reduction of ambulatory venous hypertension during walking. Such high intermittent interface pressure peaks exerting a "massaging effect" may rather be achieved by short stretch multilayer bandages than by elastic stockings. Conclusion: Compression is a cornerstone in the management of venous and lymphatic insufficiency. However, this treatment modality is still underestimated and deserves better understanding and improved educational programs, both for patients and medical staff.

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Section: Mode Of Actionmentioning

confidence: 99%

Compression Therapy: Clinical and Experimental Evidence

Partsch

2012

Annals of Vascular Diseases

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“…11 He applied the system with a pressure of 34 mmHg, which was comfortable for him. There were no problems during the night and he came back with a pressure readjusted to 36 mmHg on the next day.…”

Section: Measurement Of Compression Pressurementioning

confidence: 99%

Self-management by firm, non-elastic adjustable compression wrap device [Translation of Druckmessungen unter Klettverschluss-Kompression - Selbstbehandlung durch feste, unelastische Beinwickelung]

Mosti¹,

Partsch

2017

Veins and Lymphatics

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Severe forms of chronic venous insufficiency and lymphedema require strong compression-pressure, which exceeds the pressure exerted by medical compression stockings (>40 mmHg). The aim was to investigate if patients are able to apply a Velcro-band compression device (Circaid Juxta Lite™) themselves with sufficient pressure. Thirty-one patients (CEAP C6=23, C5=5, C3=2, mixed ulcer=1) applied Juxta Lite™ on their own legs after a short instruction and were asked to readjust the pressure by their subjective feeling. Sub- bandage pressure was measured after application and 24 h later. In 30 patients without arterial occlusive disease the median sub- bandage pressure values on day 1 and day 2 were 44,5 mmHg (IQR 42-48), and 46 mmHg (IQR 44-48,25) respectively. One patient with an arterialvenous leg ulcer showed pressures of 34 and 36 mmHg. All measured pressure values corresponded to the pursued target range, demonstrating that adequate self application of Velcro bands is feasible and that patents can maintain this pressure by re-adjustment.Source: this paper is an abridged translation of Mosti G, Partsch H. Druckmessungen unter Klettverschluss-Kompression - Selbstbehandlung durch feste, unelastische Beinwickelung. Vasomed 2017;5:212-6.

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“…On the other hand, the provoked temporal ischaemia of the skin during the compression phase results in hyperaemia due to the mechanism of reactive vasodilatation, which increases the blood flow to the peripheral arteries [2][3][4][5][6][7]. In this way (a reduction of venous pressure with an increase of arterial pressure) [8], the arterial-venous pressure gradient increases, thus improving the perfusion of the tissues, as well as their oxygenation and nourishment [9][10][11]. Apart from the described mechanism of action, this form of intermittent compression affects coagulation and is responsible for releasing many substances beneficial to the vessel walls [4,[12][13][14][15][16].…”

Section: Mechanism Of Actionmentioning

confidence: 99%

Usefulness of intermittent pneumatic compression in medicine

Sutkowska¹

2017

Physiotherapy

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Many studies exist that document the use of intermittent pneumatic compression in lymphedema, venous ulcers, prophylaxis of deep vein thrombosis and limb ischaemia. This article discusses the basics and usefulness of this therapy on the basis of available studies and recommendations. As the method is characterized by lack of serious side effects, good patient compliance, and high effectiveness, intermittent pneumatic compression should be taken into consideration as an alternative or additional treatment in many conditions.

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Compression therapy in mixed ulcers increases venous output and arterial perfusion

Cited by 159 publications

References 34 publications

Compression Therapy: Clinical and Experimental Evidence

Compression Therapy: Clinical and Experimental Evidence

Self-management by firm, non-elastic adjustable compression wrap device [Translation of Druckmessungen unter Klettverschluss-Kompression - Selbstbehandlung durch feste, unelastische Beinwickelung]

Usefulness of intermittent pneumatic compression in medicine

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