Compression Garments and Bandages

Compression Garments and Bandages

PEP Topic 

A compression garment is a knit, two-way stretch sleeve or stocking that is worn to assist in controlling swelling and to aid in moving lymph fluid from the affected area. It should be worn only while the patient is awake and active and should be custom fitted. Compression bandaging (CB) is a specialized form of compression used in the treatment of lymphedema. Bandages are the most effective and flexible form of compression, particularly in the early stages of treatment, and they provide proper compression when the patient is active or resting. They also can be easily adjusted to fit changing limb size and compression needs. Multiple layers of short-stretch bandages are applied to the lymphedematous area(s). Short-stretch bandages have limited extensibility under tension (50%), in contrast to Ace® bandages (300%). To achieve an effective compression gradient, bandages must be strategically applied with low-to-moderate tension using more layers in the distal portions of the affected limb(s). Pressure within the short-stretch bandages is low when the patient is inactive (resting pressure). Muscle contractions increase interstitial pressure (working pressure) as muscles expand within the limited volume of the semi-rigid bandages. Interstitial cycling between low-resting and high-working pressures creates an internal pump that encourages movement of congested lymph along the distal to proximal gradient created by bandaging. The non-elastic bandage sheath also counters refilling of fluid and reduces tissue fibrosis, further reducing volume.

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