Compression bandage phlebological

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

phlebological compression bandage

Definition
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Method of compression therapy for phlebological and lymphological diseases. The phlebological compression bandage includes at least one large joint.

Indication
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Implementation
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S.u. Compression therapy. The application of the bandage requires special knowledge and experience. The phlebological compression bandage (PKV) can be applied as an alternating bandage or as a permanent bandage. The alternating bandage is changed daily. The permanent bandage remains in place for a longer period, usually several days. The PKV includes at least one large joint.

  • Reusable materials: ideal bandage according to DIN 61631; textile elastic bandage; permanently elastic bandage; cohesive bandage.
  • Non-reusable materials: adhesive materials; rigid bandage (zinc paste bandage).

The phlebological compression bandage can be applied using various techniques - e.g. Pütter, Sigg, Altenkämper. An example is the Pütter technique of wrapping two short-stretch bandages in opposite directions (Pütter technique):

  • 1st bandage: Starting at the back of the foot from inside to outside.
  • 2nd bandage: Starting at the back of the foot from the outside to the inside.

Guidelines for Compression Therapy according to Wienert:

  • If possible, apply bandage only when the ankle joint is at 90°.
  • Include the heel.
  • Cover the metatarsophalangeal joints of the toes with the bandage.
  • Lead the lower leg compression bandage (two bandages) up to the head of the fibula, the thigh bandage up to the proximal thigh.
  • The pressure of the bandage should decrease from distal to proximal.
  • The bandage should not cause pressure points, lacerations or pain.
  • The material and application technique should be adapted to the clinical picture.
  • To avoid pressure points, padding should be applied locally or padded underneath.

Contraindication
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Absolute contraindications: Advanced AVC, decompensated heart failure, septic phlebitis, phlegmasia coerulea dolens.

Relative contraindications are weeping dermatoses, intolerances or allergies to the material, peripheral polyneuropathies, still compensated peripheral arterial disease, rheumatoid arthritis.

see also compression therapy

Remember! Unsuitable or incorrectly applied compression bandages can cause skin necrosis and nerve pressure damage!

Literature
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  1. Arnoldi CC (1976) Elastic compression in the prevention of venous thrombosis. VASA 5: 101-106
  2. Wienert V et al (1996) Guidelines on medical compression stockings (MCS). Phlebology 25: 204-206
  3. Kahn SR et al (2003) Use of elastic compression stockings after deep venous thrombosis: a comparison of practices and perceptions of thrombosis physicians and patients. J Thromb Haemost 1: 500-506
  4. Kahn SR et al (2003) Effect of graduated elastic compression stockings on leg symptoms and signs during exercise in patients with deep venous thrombosis: a randomized cross-over trial. J Thromb Haemost 1: 494-499
  5. van Geest AJ et al (2003) Medical elastic compression stockings in the treatment of venous insufficiency. Curr Probl Dermatol 31: 98-107

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Last updated on: 29.10.2020