Wound Care and Compression: The Basics

Published in Complex Rehab on October 04, 2022

By Heather Trumm, Director, VGM Wound Care

Within the wound care space are many different types of compression that can be used to manage wounds. When looking at which type to use, it depends a great deal on the person’s disease state. The disease state we see most is venous disease.

Venous Disease

More than 30 million Americans suffer from venous disease. What is venous disease and why does it involve wounds? Venous disease occurs primarily in older adults, though it can be found in younger individuals as well. The valves of the venous system in the lower extremity are faulty and don’t effectively push the venous blood back to the heart. As a result, pools of blood and fluids in the lower extremities cause inflammation and swelling. The pressure of the fluid can cause a wound, but wounds may also develop from an encounter with an object (coffee table, etc.). When the wound occurs, it’s difficult for it to heal because of the poor venous blood flow back to the heart. That is where compression comes into play.

Compression and Venous Disease

When it comes to compression, there are certain factors that are very important to consider. Ideally, the blood should go back to the heart, but if an individual has other comorbidities or disease states that are happening within the body (such as peripheral artery disease, which means narrowing of the arteries), the compression of an artery must be avoided. The blood must circulate to where it needs to be.

With compression, there's a measurement called an ankle brachial index (ABI), which essentially gives a measurement of one’s blood pressure of their extremities. It provides a guide for nurses and compression professionals on how much compression should be used in millimeters of mercury (mm) to compress that lower extremity to where it's beneficial, yet not harmful to the patient.

Because of the complexity of compression and all the factors to consider, it is so important for DME and HME providers to have an educated, trained member of the team who does the fitting of compression.

Helpful Tools

If clinicians or podiatrists are struggling with what to do when it comes to compression, the WOCN Society has a VLU algorithm to help the clinician identify the need for compression and which type the individuals need. Click here to learn more.

For further questions on compression, contact Heather Trumm, Director of VGM Wound Care, at [email protected]

References

Alavi A, Sibbald RG, Phillips TJ, et al. What's new: management of venous leg ulcers: treating venous leg ulcers. J Am Acad Dermatol. 2016;74(4):643–666.

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