Compression Therapy

Elastic compression hose in this country are the initial mainstay of treatment for mild to moderately severe chronic venous insufficiency, or CVI. For more severe problems, such as marked thickening and discoloration of the skin, a higher compression hose or "double hose" treatment is recommended, at least initially.

These elastic hose may exert from 20 to 50 mm of mercury in the lower leg and ankle, and the pressure gradually becomes less, higher in the leg. When an ulcer has formed, or in severe CVI, the initial treatment is a less elastic compression, usually a moist wrap commonly referred to as an Unna Boot. A more recent therapy, which is easier to wear and apply while still being very effective, is the CircAid device.

Compression therapy works by doing several things. It increases the tissue pressure and thereby decreases the edema rather quickly. It also decreases the venous volume, while increasing the velocity of venous flow, and shifts the blood into the deep system. It markedly increases the effectiveness of the calf muscle pumping action by giving the muscle "something to push against," which also helps decrease the venous pressure. In addition to the improvement of the venous system, compression therapy also has beneficial effects on the inflammation in the soft tissues that inevitably accompanies CVI. The lymphatic system is also helped by compression in similar ways.

Compression therapy plays an important part in phlebology, in initial therapy, after procedures and injections, and sometimes long-term as treatment or as a preventive measure in chronic deep venous disease.

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