Neue Entwicklungen in der Kompressionstherapie

Abstract

Patients with peripheral arterial occlusive disease who show an ankle arterial pressure of minimum 60 mmHg can be decongested by use of special padded bandages. Afterwards, medical compression stockings (class 1) with high strength and less elasticity are recommended. Mobile patients seem to benefit from progressive compression therapy with highest pressure above the calf. Compression after uncomplicated interventions of varicose veins or spider veins tends to be modified to a short and excentric compression in patients without risk factors. Valid datas are not available yet. Adaptive compression bandages show pros concerning efficiency, economy and more comfort for patients with edemas or ulcers.

Von Gummibandagen und Gummistrümpfen zur Hightech-Therapie: Seit Jahrzehnten gilt die Kompressionstherapie als Basismaßnahme in der phlebologischen und lymphologischen Therapie. Lange Zeit gab es nur marginale Veränderungen von Indikationen, Kontraindikationen, Anwendungen und Materialien. In den letzten Jahren aber überraschten zahlreiche Studienergebnisse und neue Entwicklungen, die eine dosierte und individualisierte Therapie ermöglichen.

Schlüsselwörter

Kompressionstherapie - Druckgradient - Ödem - Ulcus cruris

Key words

compression therapy - pressure gradient - edema - ulcus cruris

• Literatur

• 1 Rabe E. Hertel S. Bock E. et al. Therapy with compression stockings in Germany – results from the Bonn Vein Studies. J Dtsch Dermatol Ges 2013; 11: 257-261
• 2 Deutsche Gesellschaft für Phlebologie. Leitlinie Phlebologischer Kompressionsverband. http://www.awmf.org/uploads/tx_szleitlinien/037005_S2_Phlebologischer_Kompressionsverband_PKV_2009_abgelaufen.pdf Zugriff 06.02.2016
• 3 Wienert V. Gerlach H. Gallenkemper G. et al. Medical compression stocking (MCS). J Dtsch Dermatol Ges 2008; 6: 410-415
• 4 Mosti G. Iabichella ML. Partsch H. Compression therapy in mixed ulcers increases venous output and arterial perfusion. J Vasc Surg 2012; 55: 122-128
• 5 Schuren J. Bernatchez SF. Tucker J. et al. 3M Coban 2 layer compression therapy: Intelligent compression dynamics to suit different patient needs. Adv Wound Care (New Rochelle) 2012; 1: 255-258
• 6 Humphreys ML. Stewart AH. Gohel MS. et al. Management of mixed arterial and venous leg ulcers. Br J Surg 2007; 94: 1104-1107
• 7 Ladwig A. Haase H. Bichel J. et al. Compression therapy of leg ulcers with PAOD. Phlebology 2014; 29: 7-12
• 8 Jünger M. Haase H. Schwenke L. et al. Macro- and microperfusion during application of a new compression system, designed for patients with leg ulcer and concomitant peripheral arterial occlusive disease. Clin Hemorheol Microcirc 2013; 53: 281-293
• 9 Stücker M. Link K. Reich-Schupke S. et al. Compression and venous ulcers. Phlebology 2013; 28: 68-72
• 10 Flour M. Clark M. Partsch H. et al. Dogmas and controversies in compression therapy: report of an International Compression Club (ICC) meeting, Brussels, May 2011. Int Wound J 2013; 10: 516-526
• 11 Benigni JP. Sadoun S. Allaert FA. et al. Efficacy of Class 1 elastic compression stockings in the early stages of chronic venous disease. A comparative study. Int Angiol 2003; 22: 383-392
• 12 Vayssairat M. Ziani E. Houot B. Placebo controlled efficacy of class 1 elastic stockings in chronic venous insufficiency of the lower limbs. J Mal Vasc 2000; 25: 256-262
• 13 Jonker MJ. de Boer EM. Adèr HJ. et al. The oedema-protective effect of Lycra support stockings. Dermatology 2001; 203: 294-298
• 14 Partsch H. Winiger J. Lun B. Compression stockings reduce occupational leg swelling. Dermatol Surg 2004; 30: 737-743
• 15 Blazek C. Amsler F. Blaettler W. et al. Compression hosiery for occupational leg symptoms and leg volume: a randomized crossover trial in a cohort of hairdressers. Phlebology 2013; 28: 239-247
• 16 Mosti G. Kompressionstherapie bei Veneninsuffizienz und arteriellen Erkrankungen. Phlebologie 2014; 43: 127-133
• 17 Brizzio E. Amsler F. Lun B. et al. Comparison of low-strength compression stockings with bandages for the treatment of recalcitrant venous ulcers. J Vasc Surg 2010; 51: 410-416
• 18 Clarke-Moloney M. Keane N. O'Connor V. et al. Randomised controlled trial comparing European standard class 1 to class 2 compression stockings for ulcer recurrence and patient compliance. Int Wound J 2014; 11: 404-408
• 19 Milic DJ. Zivic SS. Bogdanovic DC. et al. The influence of different sub-bandage pressure values on venous leg ulcers healing when treated with compression therapy. J Vasc Surg 2010; 51: 655-661
• 20 Nelson EA. Bell-Syer SE. Compression for preventing recurrence of venous ulcers. Cochrane Database Syst Rev 2014; 9: CD002303
• 21 Reich-Schupke S. Murmann F. Altmeyer P. et al. Compression therapy in elderly and overweight patients. Vasa 2012; 41: 125-131
• 22 Renner R. Gebhardt C. Simon JC. Compliance to compression therapy in patients with existing venous leg ulcers. Results of a cross-sectional study. Med Klin (Munich) 2010; 105: 1-6
• 23 Sippel K. Anziehhilfen für Kompressionsstrümpfe. Phlebologie 2015; 44: 339-343
• 24 Mosti G. Partsch H. Compression stockings with a negative pressure gradient have a more pronounced effect on venous pumping function than graduated elastic compression stockings. Eur J Vasc Endovasc Surg 2011; 42: 261-266
• 25 Couzan S. Assante C. Laporte S. et al. Booster study: comparative evaluation of a new concept of elastic stockings in mild venous insufficiency]. Presse Med 2009; 38: 355-361
• 26 Mosti G. Partsch H. Compression stockings with a negative pressure gradient have a more pronounced effect on venous pumping function than graduated elastic compression stockings. Eur J Vasc Endovasc Surg 2011; 42: 261-266
• 27 Couzan S. Leizorovicz A. Laporte S. et al. A randomized double-blind trial of upward progressive versus degressive compressive stockings in patients with moderate to severe chronic venous insufficiency. J Vasc Surg 2012; 56: 1344-1350
• 28 Mosti G. Partsch H. Improvement of venous pumping function by double progressive compression stockings: higher pressure over the calf is more important than a graduated pressure profile. Eur J Vasc Endovasc Surg 2014; 47: 545-549
• 29 Jünger M. 57.Jahrestagung der DGP 2015. https://www.md-institute.com/de/id-57-jahrestagung-dgp-bamberg-23-29-09-2015.html?file=files/cto_layout/pressemitteilungen/kompressionstherapie/downloads/Phlebologen-Kongress-Bamberg-2015.pd
• 30 Deutsche Gesellschaft für Phlebologie. Leitlinie Diagnostik und Therapie des Krampfaderleidens. https://phlebology.de/en/leitlinien-der-dgp-mainmenu/archiv/7-leitlinie-zur-diagnostik-und-therapie-des-krampfaderleidens Zugriff 16.02.2016
• 31 Hamel-Desnos CM. Guias BJ. Desnos PR. et al. Foam sclerotherapy of the saphenous veins: randomized controlled trial with or without compression. Eur J Vasc Endovasc Surg 2010; 39: 500-507
• 32 Morrison N. Gibson K. McEnroe S. et al. Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous veins (VeClose). J Vasc Surg 2015; 61: 985-994
• 33 Tisi PV. Beverley C. Rees A. Injection sclerotherapy for varicose veins. Cochrane Database Syst Rev 2006; 18: CD001732
• 34 Breu FX. Kompressionstherapie nach Sklerotherapie: pro Kompression. Vasomed 2016; 28: 28-29
• 35 Partsch B. Kompressionstherapie nach Sklerotherapie: kontra Kompression. Vasomed 2016; 28: 30-31
• 36 Ragg JC. Exzentrische Kompression nach Schaumverödung großer Varizen mit neuartigem Silikongel-Polster. Phlebologie 2014; 43: 250-256
• 37 Damstra RJ. Partsch H. Prospective, randomized, controlled trial comparing the effectiveness of adjustable compression Velcro wraps versus inelastic multicomponent compression bandages in the initial treatment of leg lymphedema. J Vasc Surg Vein Lymph Dis 2013; 1: 13-19
• 38 Mosti G. Cavezzi A. Partsch H. et al. Adjustable Velcro Compression Devices are more effective than inelastic bandages in reducing venous edema in the intial treatment phase: a randomized controlled trial. Eur J Vasc Endovasc Surg 2015; 50: 368-374
• 39 Nugent L. Juxta Cures: compression for healing venous leg ulcers. Br J Community Nurs 2013; S40: 42-45
• 40 Harding KG. Vanscheidt W. Partsch H. et al. Adaptive compression therapy for venous leg ulcers: a clinically effective, patient-centred approach. Int Wound J 2014 [Epub ahead of print]