The rationale for compression leg garments is to simulate the effect of standing in deep water, as described earlier. They compress the superficial veins and soft tissues and protect against high intravenous pressure in them generated by standing and walking. In effect, the ideal elastic garment permits one to walk around in his or her own simulated swimming pool throughout the day. Indeed, compression wraps and garments make up the cardinal interventions for long-term, successful therapy of venous valvular reflux disease.
We begin mobile compression therapy with the elastic wrap. It can be used quite expediently, especially on starting treatment of venostasis edema.
Wrapping the leg with an elastic bandage is generally a temporary measure for initial control of symptoms from venous insufficiency. It will promote reduction of edema and ease symptoms during the time required for therapeutic stockings to be measured, manufactured, and received. With greatly swollen legs, using the elastic wrap for several weeks before measuring for a stocking may be judicious. This extended time will allow for maximum reduction in size. The wrap can be used in persons who are unable to use a therapeutic stocking because of cost, misshapen leg, or personal dislike. For them, the wrap can become a permanent and effective mainstay of treatment.
Wrapping an elastic bandage on oneself is challenging. It requires some hand strength and the ability to bend comfortably. For many with limited strength and agility, it is necessary that another person apply the bandages.
The elastic bandage has the advantage of permitting application of strong pressure in the ankle region where the greatest venous pressures are developed, and where the tissue is most vulnerable. The wrapping can be adapted to all but the most grossly misshapen leg contour. A second bandage applied higher up on the leg is wrapped at somewhat less pressure, thus providing some degree of graduated compression.
Improperly applied, elastic bandages have a tendency of working themselves loose. They may also cinch up above the bulk of the calf when they then act adversely by acting as a tourniquet. In addition, some find it difficult to apply the proper degree of pressure consistently with each wrapping.
By elastic, we refer to the property of a bandage that allows stretching two or three times its resting length before distortion of the fabric. On releasing, the bandage will spring back to its original length. Elasticity is built in bandages by incorporating rubberized or synthetic fibers into the textile or by interweaving fibers of different materials which tend to return to a neutral point after being stretched. When applied under tension around the leg, the bandage exerts continuous pressure. On stepping, the bulging of the calf muscles against the bandage increases the force on the internal structures.
Highly elasticized bandages have proved manageable and effective in the vast majority of ...