Compression Therapy In Patients Research Articles

Comparison of two ablation procedures combined with high ligation and foam sclerotherapy and compression therapy for patients with venous leg ulcers

ABSTRACT Aim To compare the ablation techniques’ efficacy of endovenous microwave ablation (EMA) combined with high ligation (HL), foam sclerotherapy (FS) and compression therapy (CT) and endovenous laser ablation (EVLA) combined with HL-FS-CT in the treatment of VLUs. Method 301 consecutive patients with VLUs from 2013 to 2022 in a 3200-bed hospital were intervened by EMA combined with HL-FS-CT and EVLA combined with HL-FS-CT were retrospectively compared. Results One hundred thirty-four patients underwent EMA+HL-FS-CT and 167 patients underwent EVLA+HL-FS-CT. The primary outcome of the ulcer healing time was 1.45(0.75–1.5) months and 1.86(0.5–2.5) months, respectively, in the two groups (HR for ulcer healing was 1.26, 95% CI [0.96–1.66], p = 0.097). Secondary outcomes included that no significant difference was found in ulcer recurrence and GSV recanalization and complications between the two groups, and the postoperative VCSS and AVVQ were significantly lower than the baseline values in the respective groups (p = 0.0001). Conclusion EMA+HL-FS-CT and EVLA+HL-FS-CT are both effective at treating VLUs. Both of the two comprehensive treatments were beneficial to the healing of ulcers, but no evidence showed which one was superior in the ulcer healing time.

Compression therapy in patients with venous leg ulcers: a best practice implementation project.

Venous leg ulcers are the most common ulcerations of the lower extremities. Compression is the most important consideration and the gold standard treatment for venous leg ulcers. This implementation project aimed to promote best practices in the management of venous leg ulcers in a rural community-care setting. This project was guided by the JBI Evidence Implementation Framework, which is grounded in audit and feedback processes, along with a structured approach to identifying and managing barriers to compliance with recommended best practices. Compliance with best practices increased for most audit criteria. The use of compression therapy increased from 16.7% to 60%, documentation increased from 6.7% to 50%, replacement of compression bandages from 6.7% to 60%, patient education from 0% to 46.7%, and holistic assessment from 0% to 13%. However, compliance for individualized interventions to promote adherence remained at 0%. This project succeeded in introducing compression therapy as a basic treatment for venous ulcers. However, continued improvement in the care for venous ulcers and guarantee of long-term implementation of evidence are necessary. http://links.lww.com/IJEBH/A212.

Adherence to Elastic Compression Therapy in Patients With Chronic Venous Disease

Adherence to Elastic Compression Therapy in Patients With Chronic Venous Disease

Effects of pneumatic compression therapy on wound healing in patients with venous ulcers: A meta-analysis.

This meta-analysis assessed the effect of pneumatic compression therapy on the wound healing of venous ulcers, with the aim of providing a basis for the selection of clinical treatment. Randomised controlled trials (RCTs) on the application of pneumatic compression therapy to venous ulcers were collected by searching PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP, and Wanfang databases, with a timeframe from database inception to August 2023. After two researchers independently screened the literature, extracted information, and evaluated the quality of the included studies, a meta-analysis was performed using RevMan 5.4 software. Six RCTs with 367 patients were included, with 172 patients in the intervention group and 195 in the control group. The results showed that pneumatic and bandage compression therapies had a similar impact on wound healing rates of venous ulcers (54.65% vs. 53.84%, odds ratio [OR]: 1.02, 95% confidence interval [CI]: 0.49-2.12, p = 0.96), changes in wound area (standardised mean difference: -0.16, 95% CIs: -0.45 to 0.12, p = 0.26), adverse event rates (76.56% vs. 67.07%, OR: 1.62, 95% CI: 0.77-3.39, p = 0.20), and the differences were not statistically significant. Thus, current evidence suggests that the effects of pneumatic compression therapy on wound healing rates, changes in wound area, and the incidence of adverse events in patients with venous ulcers are similar to those of bandage pressure therapy. However, owing to the limitations in the number and quality of studies, more high-quality RCTs are needed to clarify the feasibility and economics of pneumatic compression therapy in patients with venous ulcers.

Daily Duration of Compression Treatment in Chronic Venous Disease Patients: A Systematic Review.

Background: There are no data on the daily regimen of compression therapy in patients with chronic venous disease. This systematic review aimed to establish the optimal daily duration of compression treatment. Methods: A systematic search of CENTRAL and MEDLINE was performed to identify RCTs, non-RCTs, reviews, systematic reviews, meta-analyses, and guidelines evaluating the use of compression regimens in the treatment of varicose veins. Results: Thirty-two RCTs, three non-RCTs, four observational studies, and two crossover trials reporting the duration and regimes of compression treatment fulfilled the inclusion criteria. The daily duration of compression was reported in patients after invasive treatment, for venous ulcer treatment, in patients with venous symptoms. The quality of the studies varied. We could not conduct a meta-analysis due to the heterogeneity of the research data and their quality. Twenty-three studies reported results of compression usage after invasive procedures. Eight studies reported daily duration regimens in patients with venous ulcers. Nine studies reported the impact of compression on venous symptoms and/or edema or limb volume change. One study was conducted to assess if compression improves QoL in venous patients. While there was a clear difference found in the daily duration depending on the clinical scenario, no data in support of exact regimens were found. Conclusions: There are no reliable data supporting exact daily regimens of compression treatment in various cohorts of CVD patients.

Terapi Kompresi pada Pasien Vena Varises yang Menjalani Operasi

This study aims to determine the effectiveness of compression therapy in varicose veins patients to reduce pain and increase wound healing after surgery. The method used was a systematic review using a checklist of protocols and rules (PRISMA) and a flowchart with the feasibility of studies assessed using the PICOT framework, searches using five databases, Science Direct, CINAHL, Scopus, SAGE, and ProQuest. The results showed that as many as ten articles were obtained discussing the effects of compression therapy in patients with varicose veins, with different discussions in each study bringing positive impacts. In conclusion, compression therapy is considered the most effective conservative treatment for varicose veins, which has been shown to benefit from several research results. Namely, compression improves the healing of varicose veins compared to no reduction. Still, compression therapy has not been proven to provide long-term effects—benefits for postoperative varicose veins patients to return to normal activities.
 Keywords: Surgery, Compression Therapy, Varicose Veins

Effectiveness of manual lymphatic drainage for breast cancer-related lymphoedema: an overview of systematic reviews and meta-analyses

There are several studies on the treatment of breast cancer-related lymphedema (BCRL) based on the manual lymphatic drainage (MLD) technique, making it a widely accepted conservative treatment for BCRL. In this study, PubMed, Embase and Cochrane Library databases were searched for systematic reviews (SRs) or meta-analyses (MAs) from inception till 28 March 2022. The methodological quality of the included SRs/MAs was evaluated using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), and the evidence quality of outcome measures using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Grading of Recommendations, Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) was used to describe the certainty of evidence from qualitative data. The study results identified 7 eligible SRs/MAs. Evaluation using AMSTAR-2 revealed only one moderate quality study, while the others were rated as low or critically low. The GRADE criteria identified 3 very-low-quality evidence studies, 1 low-quality evidence study, and 9 moderate-quality evidence studies. The GRADE-CERQual assessment showed the confidence for decision-making was either low or moderate. Overall, the results indicated that MLD could significantly reduce lymphedema in patients aged <60 years (standard mean difference (SMD): −1.77, 95% confidence interval (CI): (−2.23 to −1.31)), and the optimal intervention duration was 1 month. Although MLD for BCRL might reduce lymphoedema volume, their effects were not well established, and therefore, we could not recommend the addition of MLD to complete decongestive therapy (CDT) or compression therapy for patients with BCRL. Thus, MLD treatment appeared to be an ambiguous but potentially effective BCRL treatment. Rigorously designed high-quality randomized controlled trials with larger sample sizes are needed to further verify the effectiveness of MLD therapy in BCRL treatment.

Initiating compression therapy for those living with heart failure.

Compression therapy is used to treat leg symptoms arising from chronic venous disease and lymphoedema. Heart failure, which is traditionally regarded as a contraindication for compression therapy, is prevalent among patients with such leg symptoms. This article aims to assess the evidence on the safety and effectiveness of compression therapy, as well as recommending the assessment and measures required when initiating compression therapy in patients with heart failure. Recent evidence suggests that initiating compression therapy in patients with stable and compensated heart failure is safe if appropriate precautionary measures are undertaken. However, there is still insufficient evidence to support the safety of compression therapy in patients with severe and decompensated heart failure. A standardised, evidence-based guideline on compression therapy in patients with heart failure will help medical and nursing professionals and improve informed consent for the patients.

ПРИМЕНЕНИЕ КОМПРЕССИОННОЙ ТЕРАПИИ ПАЦИЕНТАМИ С ВАРИКОЗНОЙ БОЛЕЗНЬЮ НИЖНИХ КОНЕЧНОСТЕЙ

Objective. To study the implementation of medical recommendations regarding the use of compression therapy in patients with varicose veins of the lower extremities. Methods. A prospective comparative study, Patients Commitment to Compression Therapy (POMP), was conducted with the participation of phlebologist-surgeons who treat patients with chronic venous diseases in Minsk, Vitebsk, and Gomel. During 5 weeks each of the phlebologists included in the study patients with varicose veins who sought advice and needed compression therapy. 30-35 days after the consultation of the surgeon-phlebologist, an outsourcing call center conducted a telephone survey of patients in order to obtain information about the specifics of fulfilling medical recommendations. Results. The registration data base of the study contained individual data on 394 patients with varicose veins (C1-C6) who received recommendations to use compression therapy. After 30-35 days, 302 patients (aged 43, 18-84 (Me, IQR)) were available for telephone survey. There were 58 men (19.2%), 244 women (80.8%). Among them, class C1 was registered in 39 (12.9%), C2 - in 113 (37.4%), C3 - in 122 (40.4%), C4 - in 25 (8.3%), C5 - in 1 (0.3%), C6 - in 2 (0.7%) patients. It was found that 245 (81.5%) of the respondents either already had compression hosiery at the time of the consultation, or purchased it within 30 days. 228 (75.2%) respondents reported compliance with the recommendations. Patients who had already experience with compression therapy and patients with the history of venous thromboembolism showed higher commitment to compression therapy (p<0.001). There were no significant differences in the compliance of patients with different levels of education and professional characteristics. Conclusion. A high commitment of patients to compression therapy was established 1 month after receiving recommendations. To obtain more information about patient compliance, it is necessary to enlarge the follow-up period. What this paper adds In a prospective multicenter study a high commitment (75.2%) to compression therapy for patients with varicose veins was firstly defined 1 month after the recommendations made by a phlebologist to use it.

An audience survey of practice relating to pain in the management of chronic venous leg ulcers.

Venous leg ulcers (VLU) respond well to compression, yet many ulcers remain unhealed after 1 year. Practitioners could be reluctant to apply compression to patients with significant ulcer pain. This study aimed to capture the views of practitioners on compression therapy for patients with painful VLU. A survey was conducted at a UK meeting in 2019 using handheld voting pads to capture the anonymous responses to four questions to which a mean of 90 practitioners responded. Nearly 40% of practitioners treat six or more patients a day with painful lower-limb ulcers. Some 80% felt confident in managing patients with painful ulcers; yet, most practitioners suggested they would refer onward for pain management. Some 40% would omit or reduce compression therapy as a pain management strategy. This survey supports the need for technological solutions that reduce VLU pain so that patients receive effective compression therapy.

Ultrasound-guided thrombin injection versus ultrasound-guided compression repair in the treatment of post-catheterization femoral artery pseudoaneurysm: King Saud University Medical Center Experience.

This study aims to evaluate the effectiveness of ultrasound-guided thrombin injection versus ultrasound-guided compression repair in the management of iatrogenic femoral artery pseudoaneurysms. Between June 2006 and December 2015, a total of 29 consecutive patients (15 males, 14 females; mean age 54 years; range 26 to 81 years) with a femoral pseudoaneurysm treated by ultrasound-guided thrombin injection were retrospectively analyzed. These patients were compared with a historical group of 36 patients (21 males, 15 females; mean age 44 years; range 32 to 65 years) who underwent ultrasound-guided compression repair between February 1999 and May 2006. Medical records and vascular laboratory findings of all patients were reviewed. Successful treatment was defined as complete cessation of flow into the false lumen with preservation of flow in the femoral artery. The ultrasound-guided thrombin injection showed a success rate of 100%, whereas ultrasound-guided compression repair had a success rate of 80.5%, which was possibly affected by anticoagulant therapy, hypertension, and an aneurysm size of >6 cm. However, none of these factors did not affect the success of thrombin injections. Ultrasound-guided thrombin injection is a highly successful, easy to perform, accepted, and well-tolerated method by patients. It is more effective compared to compression therapy in patients with hypertension, large aneurysms, and who are on anticoagulant therapy.

Safety of compression therapy for venous ulcer disease in the setting of congestive heart failure.

Compression therapy is the mainstay of treatment for patients with venous ulcer disease. There exists a lack of certainty as to the safety of compression therapy in patients with congestive heart failure. A retrospective review of 95 patients with the diagnosis of congestive heart failure (systolic, diastolic, or combined), who underwent compression therapy at the wound care center of a large teaching hospital between January 2013 and June 2019, was performed. Patient outcomes including mortality, weight gain, admission for heart failure decompensation, and requirement for diuretic dose increase were compared to the general congestive heart failure population as well as to the registry data. In the compression cohort, with a mean compression period of 310 days, seven patients (7.3%) were admitted for congestive heart failure exacerbation and six (6.3%) underwent diuretic dosage increase. Two patients (2.1%) died during the compression period. These endpoints were not significantly higher than within the general congestive heart failure population. Compression therapy appears safe amongst patients with stable congestive heart failure.

The Most Severe Stage of Chronic Venous Disease: An Update on the Management of Patients with Venous Leg Ulcers.

Venous leg ulcers (VLUs) are the most severe manifestation of chronic venous disease (CVD). Due to their chronic nature, high recurrence rate and slow healing time, VLUs account for 80% of all leg ulcers seen in patients with CVD. VLUs impose a heavy burden on patients that reduces their quality of life; VLUs also represent a major socioeconomic impact due to the cost and duration of care. The primary medical approach to treating VLUs is local compression therapy in combination with venoactive drug (VAD) pharmacotherapy to promote the reduction of the inflammatory reaction initiated by venous hypertension. Micronized purified flavonoid fraction (MPFF; Daflon®) is the most widely prescribed VAD. MPFF counteracts the pathophysiologic mechanisms of CVD and ulceration and has proven to be an effective adjunct to compression therapy in patients with large and chronic VLUs. Two other non-VAD drugs, pentoxifylline and sulodexide, have also been shown to improve VLU healing and are also recommended in addition to compression therapy. However, MPFF is the only VAD with the highest strength of recommendations in the 2018 guidelines for the healing of VLUs.

Innovations in medical compression therapy

For the treatment of phlebological and lymphological diseases as well as constitutional edema diseases, a discussion of innovative concepts of medical compression therapy is essential. It is recommended that medical compression stockings should always be prescribed based on symptoms and with the lowest effective interface pressure to optimize the tolerability of compression therapy. Likewise, medical compression stockings with an integrated care formula, but also the application of additional skincare can improve the quality of life and compliance in patients with chronic venous insufficiency. Optimization of ulcer therapy can be achieved by using two-component compression stocking systems. These consist of anunderstocking and afirm outer compression stocking, which improve the venous and capillary hemodynamics with good wearing comfort and lead to the healing of venous ulcerations. Multicomponent compression bandages and short stretch bandages are proven in the decongestion phase of edema. Multicomponent bandages ensure asustained interface pressure for at least 5days and are ideal for outpatient treatment with less frequent dressing changes. For compression therapy in patients with arterial-venous leg ulcers (ABI [ankle brachial index] >0.5), specially developed "lite" versions of the multicomponent dressings can be used.

Compression therapy following ClariVein\xae ablation therapy: a randomised controlled trial of COMpression Therapy Following MechanO-Chemical Ablation (COMMOCA)

BackgroundEndovenous treatment of varicose veins has increased in popularity over the last decade. There remains, however, a degree of uncertainty regarding the role of compression bandaging or hosiery following this intervention. The National Institute for Clinical Excellence Guideline Development Group has advocated further research to evaluate the clinical and cost-effectiveness of this post-procedure intervention. In addition to this, the duration of compression bandaging also warrants clarification.MethodsEthical approval for the study was obtained from the Singhealth Centralised Institutional Review Board (CIRB Ref: 2017/2710). Consent to enter the study will be sought from each participant only after a full explanation has been given, an information leaflet offered and time allowed for consideration. Signed participant consent will be obtained. Patients will be randomised to either compression (group A) or no compression (group B). The primary aim of the study is to assess the patient’s pain scores for the first 10 days post procedure using a visual analogue scale. Secondary aims include an assessment of patient compliance with compression, quality of life scores, clinical effectiveness, rates of bruising and phlebitis, time taken to return to normal activities, patient satisfaction and occlusion rate at 6 months.DiscussionThe purpose of this study is to examine the effect of compression therapy in patients having mechano-chemical ablation (MOCA) therapy for truncal incompetence of their varicose veins using the ClariVein® device. This study may provide clarification on the role of compression therapy in patients undergoing MOCA.Trial registrationClinicalTrials.gov, NCT03685838. Registered on 26 September 2018.

Compression Therapy in Patients with Leg Ulcers - which Costs do Really Occur?

Patients with leg ulcers often have severe edema of the lower extremities, which should be treated as part of a successful wound treatment. Today in Germany the necessary compression therapies are often performed with very error-prone and time-consuming short-stretch bandages only. Multicomponent systems, adaptive compression bandages and leg ulcer stocking systems are newer, much less error-prone treatment options. In addition to the often lacking knowledge, the fears of high costs are also mentioned as reasons for the lack of prescription of these systems. It was therefore our aim to investigate the costs of different treatment options, differentiated in the outpatient and inpatient sector. For the economic calculations, both material andpersonnel costs were taken into account for different scenarios. Both material and personnel costs were included in the calculation. We were able to demonstrate that the cost for a continuous compression therapy for inpatients accrues between 5.29 Euros to 18.50 Euros per day. For the outpatient setting costs of 2.29 Euros to 34.29 Euros per day were calculated. The different constellations of compression therapy can make sense thus not only for medically but also for economically aspects. As a consequence of this data, both the different systems and the economic factors of compression therapy in patients with leg ulcers should be known to the therapists. These treatment options should then be prescribed and performed according to individual factors, taking into account the needs and abilities of the patients.

Compression systems used in lymphoedema management.

British Journal of NursingVol. 27, No. 20 FocusCompression systems used in lymphoedema managementTracy GreenTracy GreenSearch for more papers by this authorTracy GreenPublished Online:12 Nov 2018https://doi.org/10.12968/bjon.2018.27.20.1150AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Hobday A. Use of compression therapy in patients with lymphoedema. Nurs Stand. 2016; 30(27):50–58. https://doi.org/10.7748/ns.30.27.50.s46 Crossref, Medline, Google ScholarInternational Lymphoedema Framework. Best practice for the management of lymphoedema. 2006. https://tinyurl.com/y8hhd66c (accessed 22 October 2018) Google ScholarMoffatt CJ, Keeley V, Franks PJ, Rich A, Pinnington LL. Chronic oedema: a prevalent health care problem for UK health services. Int Wound J. 2017; 14(5):772–781. https://doi.org/10.1111/iwj.12694 Crossref, Medline, Google ScholarMosti G, Cavezzi A, Partsch H, Urso S, Campana F. Adjustable Velcro compression devices are more effective than inelastic bandages in reducing venous edema in the initial treatment phase: a randomized controlled trial. Eur J Vasc Endovasc Surg. 2015; 50(3):368–374. https://doi.org/10.1016/j.ejvs.2015.05.014 Crossref, Medline, Google ScholarPartsch H, Moffatt C. An overview of the science behind compression bandaging for lymphoedema and chronic oedema. In International Lymphoedema Framework. Compression therapy: a position document on compression bandaging. Best practice for the management of lymphoedema. 2nd edn. 2012. https://tinyurl.com/ycxxbufj (accessed 22 October 2018) Google Scholar FiguresReferencesRelatedDetailsCited byCase study: night compression use in a patient with Milroy's diseaseAmbreen Chohan, Simon Sumner, Mairi Olivier, Justine Whitaker23 June 2022 | British Journal of Nursing, Vol. 31, No. 12Examination of the effects of a new compression garment on skin tissue oxygenation in healthy volunteersAmbreen Chohan, Lauren Haworth, Simon Sumner, Mairi Olivier, Daniel Birdsall, Justine Whitaker11 July 2019 | Journal of Wound Care, Vol. 28, No. 7Leg care: improving assessment and adherenceDrew Payne13 June 2019 | Nursing and Residential Care, Vol. 21, No. 7 8 November 2018Volume 27Issue 20ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 12 November 2018 Published in print 8 November 2018 Information© MA Healthcare LimitedPDF download

Compliance improvement of compression therapy in patients with lymphedema

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Dlouhodobá kompresivní terapie u nemocných s chronickým žilním onemocněním - představy a realita

Dlouhodobá kompresivní terapie u nemocných s chronickým žilním onemocněním - představy a realita

Evidence of compression therapy

Medical compression therapy is widely used to treat phlebologic diseases. Compression bandages as well as compression stockings are used. Compression has been identified to be an effective conservative therapy for the healing of venous ulcers and other indications. Thus, the evidence for the use of medical compression therapy and for which indications is presented. Review and systematic presentation of the evidence-based use of compression. The current literature, guidelines, and consensus statements were searched and the indications for compression therapy are presented. There is a high level of evidence that compression therapy is effective to heal venous ulcers and to prevent recurrent ulcers. The use of compression bandages and hosiery after interventional and surgical procedures for varicose veins is based on experience but not on randomized controlled trials. According to clinical experience, the healing of inflammatory skin diseases (e.g., erythema nodosum, pyoderma gangrenosum, necrobiosis lipoidica, cutaneous leukocytoclastic vasculitis, and psoriasis of the extremities) is supported by compression therapy. Compression therapy in patients suffering from venous ulcers is highly recommended.