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Compression therapy for the treatment of chronic venous insufficiency

INTRODUCTION

Compression therapy remains the cornerstone of management for patients with chronic venous insufficiency. Chronic venous disease is commonly stratified using the CEAP (Clinical, Etiology, Anatomy, Pathophysiology) classification, which grades venous disease based on the presence of dilated veins, edema, skin changes, or ulceration. (See "Classification of lower extremity chronic venous disorders", section on 'CEAP classification'.)

Chronic venous insufficiency is defined as CEAP 3 to 6 and represents advanced venous disease [1]. Chronic venous insufficiency (venous valvular reflux) is the most common cause of lower extremity ulceration, accounting for up to 80 percent of the approximately 2.5 million leg ulcer cases in the United States [2]. Annual costs in the United States for the treatment of venous ulcers are estimated at more than $2 billion from costs related to frequent physician visits, care provided by nurses, compression therapy and wound care products, and potentially hospitalization.

Medical compression therapy includes garments or devices that provide static or dynamic mechanical compression to a body region. For the treatment of lower extremity chronic venous insufficiency, static compression includes compression hosiery and compression bandages. Dynamic (intermittent) compression therapy in the form of intermittent pneumatic compression pumps and sleeves may be useful under selected circumstances.

The pathophysiology, clinical features and diagnosis, and management of chronic venous disease are discussed elsewhere. (See "Overview and management of lower extremity chronic venous disease".)

INDICATIONS

Compression therapy remains the cornerstone of management for patients with chronic venous insufficiency, particularly those with venous ulceration [3,4]. The goals of treatment are ulcer healing, and reduction of extent of edema, lipodermatosclerosis, and pain. Other treatments and local wound care are discussed separately. (See "Medical management of lower extremity chronic venous disease".)

                              

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Literature review current through: Oct 2014. | This topic last updated: Aug 18, 2014.
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