As a home health agency, we treat many clients with leg wounds. Whenever a client has edema, a build up of fluid in the legs, wound healing can be compromised. The number one cause of edema is Chronic Venous Insufficiency (CVI.) CVI is a condition where the veins in the legs are not working effectively. Blood and fluid will pool in the legs because the veins and muscles that normally move blood back up to the heart, are not working properly. Clients with chronic edema are also more prone to wounds. Any small scratch, bug bite, or scrape can lead to a wound. Wounds can also develop from the skin being stretched and compromised because of edema.
When a client has edema and a wound, wounds can take a long time to heal. Wounds may even become chronic. This is because the edema does not allow the body to bring new tissue to the damaged area, and to remove damaged tissue and metabolic waste. So, an effective way to help wounds heal and to prevent wounds in clients with edema, is to use Compression Therapy.
Compression Therapy is a process of applying compression to the legs, reducing or not allowing edema to develop. There a few different types of compression therapies including Compression Stockings, Compression Bandaging (Tubigrip), Velcro Leggings, compression pumps, and Inelastic Compression. The type of compression therapy is determined by the individual patient’s situation.
Compression stockings are elastic stockings that compress the legs. They are used for edema maintenance, but should not be used on patients with wounds. They shouldn’t be used with wounds because it is difficult to take them on and off over a wound dressing, which will impair the dressing. They will also absorb drainage from the wound. In summary, compression stockings are great for edema maintenance, but not when wounds are present. Compression stockings should be replaced at least every 6 months, because they lose elasticity over time.
Compression Bandages or Tubigrips are an elastic bandage that can go over a wound dressing. They come in different sizes, materials, and elasticities. A doctor or nurse will determine which size and material is appropriate for the specific client. They are usually applied only by a medical professional that has been trained how to apply them. Compression Bandages or Tubigrips are great for clients with both edema and wounds.
Velcro Leggings are used only for edema maintenance. They are an alternative to compression stockings. They are rolled around the legs instead of being slipped on like a stocking. So, for some clients, they can be easier to apply. Yet, they are inelastic, and consequently need to be rolled on tightly and secured well. They work better with clients that are ambulatory.
Compression pumps are sleeves that wrap around the legs and are secured with Velcro. There is tubing and bladders within the sleeves that inflates to add compression. They are typically used with clients that are in bed and lying flat. The pumps are setup on a cycle and inflate for a period and then deflate.
Caution should be used when utilizing any type of compression treatment on clients with peripheral arterial disease. All patients with edema should also keep their legs elevated when they can. Many home health care clients complain that compression is painful, especially when they have wounds. So, steps should be taken to alleviate pain while encouraging compression treatment. In home health care, compression treatment can be very effective at reducing edema and maintaining edema. It can also be very useful technique for wound care treatment with home health clients with edema.
For more information on compression therapy, please visit: https://advancedtissue.com/2014/06/benefits-compression-therapy/
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