![]() ![]() 10īacterial colonisation of the skin and chronic venous leg ulcers (VLU) is common and, in the absence of clinical signs of systemic infections, is often treated with topical antiseptics, dedicated dressings and necrotic tissue debridement. Folliculitis of the skin associated with IPC has also been reported. ![]() The occlusive barrier effect of compression devices in the toe area may add to the risk of infection, 9 which may be mitigated by toe-free compression. In many conditions treated with compression devices, such as venous ulcers and lymphoedema, concomitant bacterial and fungal colonisation or infection may be present. Based on the experts’ experience, the length of compression garments should be adapted to the region of pathological findings. 8 Possibly related to improvements in IPC systems, more recent studies investigating the safety of IPC treatment have not reported cases of IPC-related genital lymphoedema.Ĭompression of the lower leg alone may cause increased swelling of the knee region. Several cases of genital lymphoedema development or worsening after IPC treatment have been reported in a single retrospective study. wound care nurses) should be trained in applying these techniques. In addition, healthcare professionals (e.g. ![]() Prevention and treatment consist of including the forefoot and the toes in the compression with special additional compression garments. According to experts’ experience in susceptible patients, in immobile patients and, in particular, in lymphoedema, this may lead to increased swelling in the forefoot and toe area, with a theoretically increased risk of interdigital fungal infection. Whilst not reported as a complication and reversible, it may represent the physical evidence of why compression devices may cause discomfort or irritation.Ĭlassical compression devices apply low or no pressure to the flat dorsum of the forefoot and toes. It is manifest as circumferential red lines or a patch of redness, typically over fulcrum areas, where the fabric of the material rubs against the skin. Tension-induced skin stress is a frequent experts’ observation occurring in patients after a well applied bandage or measured stocking has been removed. 4 Delayed bandage changes are contributory, as these prolong contact with irritant topical applications on pre-sensitised skin of venous disease patients. A considerable number of potentially treatment-related adverse events, including irritant inflammatory skin reactions below four-layer bandage systems and short-stretch bandaging, has been described in a Canadian trial. Skin irritation may be mistaken for allergic reactions, but usually they are self-limiting, can be controlled without interruption of the compression treatment and may be prevented through adequate skin care. 2, 3 The higher incidence of itching and dryness reported with MCS when compared with TPS may be partially explained by the skin of MCS patients already being compromised due to venous congestion. Low-severity skin problems, including itching, feeling cold or warm and dry skin, are frequently associated with compression therapy. For example, in a patient with severe peripheral arterial occlusive disease (PAOD) with an ankle pressure of 60 mmHg for whom a contraindication for MCS exists, well-padded inelastic CB applied with low pressure may be appropriate even with an ankle pressure of 50 mmHg. Many of the reported risks are similar in MCS and CB but there are also some considerable differences. The use of compression therapy must be considered carefully in the presence of such conditions, and contraindications must be considered. Therefore, every patient receiving compression therapy should be screened for conditions that increase the risk of complications, and every compression device should be checked for appropriate fit and application. All of the more severe complications are very rare and occur in predisposed patients or during improper use of compression therapy. This paper reviews common risks and complications of compression therapy reported in literature ( Table 1), including skin irritation and pruritus, rare complications such as superficial venous thrombophlebitis at the upper stocking border, decompensation of heart failure or spread of bacterial and/or fungal infection, and exceptional but potentially devastating complications such as nerve damage, venous thromboembolism, arterial thrombosis and skin or limb necrosis. Risks and complications for compression therapy reported in literature
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