Many guidelines are available on CVI and leg ulcer management using compression6,11-17,19 can be delivered using bandages, devices, or stockings and has been shown to reduce edema and inflammation and improve superficial skin lymphatic function and transport within the subfascial system (Figure 5).6,10-17,25,27 Inelastic short-stretch bandages exert a massage effect during walking, reducing edema and increasing blood flow but inelastic compressions do not compress the legs when patients are at rest.25,30 Intermittent pneumatic pressure devices have similar effects and may be tolerated in patients with concomitant arterial occlusive disease.27,28 Elastic compression maintains a constantly high resting pressure independent of body position and has the lowest margin of safety because pressure remains high even when the patient is lying down (Figure 6).6,30
Skin damage has been reported even with light thromboprophylaxis stockings. Incorrect application of the bandages or fitting of the compression devices or stockings and lack of daily surveillance are important flaws in patient care, leading to adverse events.6,29
Statement 3: Compression therapy should be combined with good-quality skincare to enhance adherence to and impact of treatment.
The skin plays a vital role in assisting lymph flow and venous return and acts as a collateral route for lymph drainage.32 In patients with VH, hyperkeratosis may occur, resulting from the over-proliferation of keratin or reduced desquamation.34-37 Infrequent skin cleansing and poor skincare may exacerbate
