Are Compression Dressings Right for Your Wound?
This post was reviewed by our Director of Clinical Excellence and Oversight.
When ulcers are present, compression stockings are often the first therapy a doctor will recommended. They may also be used once the chronic wound has healed as a way to prevent it from reoccurring.
What? Who? And Why?
Compression therapy is used to treat individuals with chronic wounds, leg ulcers, thrombosis, lymphedema (swelling in the arms and legs), and lipedema (collection of fat in the lower body). The aim of compression is to apply consistent, graduated levels of pressure to reduce accumulation of the fluid that fills the space between cells, called interstitial fluid. When pressure is applied to distressed or damaged veins, it forces the valves back into position, and sends the blood back to the heart.
Compression promotes healing in several ways. Consider a venous leg ulcer, in which the vein’s valves are damaged and blood pools in the lower leg. This causes the skin to break down and an open wound can develop. The compression provides support for the leg muscles, which improves blood flow back to the heart. Other benefits include:
- Shifting fluid away from the wound
- Increasing the ability of the lymphatic system to remove toxins from the body
- Reducing swelling
- Possibly reducing levels of inflammatory substances
- Speeding healing, especially when combined with the proper dressings
Types of Compression Therapy
A variety of bandages and garments use pressure to heal wounds and other conditions. Among these are:
- Bandages with varying degrees of elasticity. These should be applied by a doctor or trained caregiver to ensure the right degree of compression.
- Short-stretch bandages that may reduce edema. These require frequent changing as the limb changes in size.
- Long-stretch bandages that stretch to several times their length and conform to the shape of the leg. They are generally used for less mobile patients.
- Non-elastic bandages that are applied wet and harden as they dry.
- Multilayer bandage systems with paired components that deliver compression. An example is a padded compression bandage and a stretch bandage. Spiral, or figure-8, wrappings can help maintain the compression over a long period of time, and while the patient is walking.
- Compression stockings. When ulcers are present, compression stockings are often the first therapy a doctor will recommended. They may also be used once the chronic wound has healed as a way to prevent it from reoccurring. These should be worn from morning until bedtime or as directed. If your doctor recommends compression stockings, make sure you know what type and what compression to order.
- Intermittent pneumatic compression. These systems inflate and deflate according to settings on an electronic control.
The aim of compression is to apply consistent, graduated levels of pressure to reduce accumulation of the fluid that fills the space between cells, called interstitial fluid.
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