Compression

The compression works down into the deep tissue layers and causes the abnormally dilated veins to constrict. The dysfunctional, no longer closing venous valves are pressed together in such a way that they can once again fulfill their valve function.

As a result, the flow speed of the venous blood increases, the return flow is normalized and the congestion is reduced. The stored tissue fluids and inflammatory substances can now be removed again. Swelling (oedema) and inflammation recede, and venous leg ulcers begin to heal.

Compression therapy is particularly recommended:

• after vein surgery to avoid bruising and to secure the result
• after sclerotherapy to achieve optimal adhesion of the veins
• in the case of phlebitis or venous thrombosis to treat swelling and congestion
• for decongestion treatment of the leg
• for all advanced venous disorders that are accompanied by severe skin changes such as hardening or an "open leg"

Compression therapy is particularly effective if the patient moves a lot. This activates the leg muscles, which increase venous drainage from the leg and massage out the swollen tissue against the stocking or bandage.

Bandage or stocking?

Every patient needs compression that is tailored to their individual needs, depending on their symptoms, requirements and the type of venous disease. It depends on whether a bandage or a stocking is more beneficial:

The bandage is mainly used when compression therapy is limited to a shorter period of time, such as at the start of decongestive treatment, after surgery, etc.

The stocking is more suitable for longer-term treatment, e.g., after thrombosis in the deep veins. It is the more elegant option, as there is no need for tedious wrapping.

Wrapping bandages correctly

Bandages are made from a wide variety of materials such as zinc paste, plasters and other elastic wrapping materials. A distinction is made between alternating and permanent bandages. Elastic bandages are mainly used for temporary bandages. They are removed in the evening and reapplied in the morning.

Permanent bandages are based on elastic adhesive materials that remain on the legs day and night and are only changed at intervals of 2 to 4 days.

The bandage only achieves an optimum effect if the correct binding material has been selected for the patient's situation and a good wrapping technique has been used. It is best to apply the bandage in the morning while the patient is still in bed. At this time, the legs are not yet swollen and unencumbered.

Start wrapping on the inside of the foot (a), wrap around the heel inwards (b), then over the forefoot once around (c), back to the heel (d), then tour after tour upwards (e, f). Finish the bandage below the knee with a round and figure-eight turn (g).

There are many different techniques for applying a bandage. It does not matter which method is used.

Basically, the bandage is applied from the foot towards the groin. It is important to wrap the legs in such a way that an even pressure is achieved, which improves the function of the veins. Short-stretch bandages 8-10 cm wide are suitable.

Dr. Sigg wrapping technique

A technique that is easy to learn was described by the Swiss physician Dr. Sigg:

• Start the bandage on the inside of the foot on the back of the foot and then roll the bandage around the foot.
• Then roll the bandage around the heel, then back to the foot and from there over the ankle.
• It is particularly important to keep the foot at a right angle when wrapping, otherwise unnecessary creases and cords will form. Make sure that no gaps are left.
• From the heel, the bandage runs in a tile-like overlap to below the knee, where it is secured with the help of clips or plasters.
• A second bandage wrapped in the opposite direction – i.e., from the inside to the outside – ensures optimum hold.
• If the bandage needs to extend to the groin, the bandage tours continue in a roof tile shape up to this point.
• As soon as the bandages are applied, you must move around in them as much as possible. This is the only way for them to take full effect.

Most common wrapping errors

Ask a doctor or other specialist to guide you when wrapping the first bandages to avoid using the wrong technique.

The most common mistakes are

• creasing
• applying too loosely
• uneven pressure

This can lead to lacerations, local congestion and pain. It is crucial that the bandage is applied evenly to the tissue. It can also happen that a bandage is wrapped too tightly. The patient then usually feels impaired when walking, their leg becomes numb, cold, tired and the forefoot turns blue. In these cases, the bandage must be removed and replaced immediately. A correctly applied bandage is perceived as a comfortable support. It makes walking easier, the pain quickly subsides and the foot remains rosy warm.

Compression stocking

Learn to live with your compression stocking. Provided they are worn consistently, they reliably prevent all the consequences and complications of chronic venous disease. The "rubber" or rather compression stocking is a simple and elegant method of exerting a constant pressure on the leg. The tedious wrapping of bandages is no longer necessary. They are often worn as a preventative measure and to relieve mild symptoms such as leg fatigue and swelling by groups of people who mainly work in a standing or sitting position, such as hairdressers, sales assistants or secretaries.

A few years ago, stockings were still bulky and thick, but nowadays state-of-the-art fabrics such as microfiber and thin cotton blends are used which, in addition to the desired compression effect, ensure optimum comfort on the skin. In addition to a wide variety of models, ranging from compression socks to tights, a wide range of colors are also available. Nowadays, they hardly differ from normal nylon tights or fashionable leggings, such as the models from SIGVARIS.

Compression stockings are available in four classes, which differ in the amount of pressure they exert on the leg. However, a perfect fit on the leg is a prerequisite for an optimum effect. For this reason, a medical compression stocking should always be worn on a decongested, slender leg – preferably early in the morning.

Putting on a compression stocking is not easy. Your doctor or nurse will explain to you what is important. Use gloves (sturdy kitchen gloves are best) and the donning aid provided. This allows the stocking to slide over your foot and leg without the risk of tearing a hole with your fingernails. Once you have finished putting them on, smooth out the last creases and check the fit. The stocking fits perfectly when the stitch pattern is evenly distributed. A stocking also needs to be well cared for. It is a good idea to get a second pair so that you can wash them every day, or at least every 2nd day. Otherwise odors and metabolic waste will settle in the elastic fibres. Use a mild detergent for cleaning and wash by hand or in the gentle cycle of the washing machine at a maximum of 30 degrees. The socks should then be left to air dry slowly. Caution: A tumble dryer or drying on a heater can destroy the fabric.