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DPT 773 - Integumentary > Compression > Flashcards

Compression Flashcards

1
Q

What is the standard compression pressure recommended at the ankle?

A

30–40 mmHg at the ankle is the standard pressure.

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2
Q

What compression pressure is recommended for patients with severe venous insufficiency?

A

40–50 mmHg can be used for severe venous insufficiency.

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3
Q

What compression pressure is recommended for patients with mild arterial insufficiency?

A

20–30 mmHg is recommended for mild arterial insufficiency.

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4
Q

What are the three primary effects of compression on the venous system?

A
  • counteracts gravity
  • removes fluid from tissues
  • improves venous return
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5
Q

What are the dynamic effects of compression during movement?

A

Dynamic effects include changes in leg circumference, when walking, that promote fluid movement out of the limb.

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6
Q

How does external pressure improve microcirculation?

A

External pressure increases limb pressure, enhancing the force needed to push fluid out and improving microcirculation.

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7
Q

What are the primary indications for using compression therapy?

A

Compression therapy is indicated for peripheral edema, scar management, and promotion of venous return.

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8
Q

What is the ABI threshold below which compression is contraindicated?

A

Compression is contraindicated if the ABI is < 0.7.

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9
Q

What conditions require caution or are contraindications for compression bandaging?

A

Conditions include:

  • uncompensated CHF
  • severe PAD
  • untreated DVT
  • active infection
  • septic phlebitis
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10
Q

Why is compression therapy initiated slowly in patients with CHF?

A

Compression is initiated slowly to ensure tolerance and avoid overloading the compromised cardiovascular system.

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11
Q

What is a contraindication for compression if absolute ankle pressure is considered?

A

Compression is contraindicated if absolute ankle pressure is less than 60 mmHg.

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12
Q

What are the general guidelines for tension in compression bandaging?

A
  • Tension is inversely related to bandage width and leg circumference
  • Narrow bandages and smaller limbs result in higher compression
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13
Q

What is the primary force created by the elastic recoil of a compression product?

A

Pressure is the primary force created by the elastic recoil.

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14
Q

What does higher stiffness in a compression product indicate?

A

Higher stiffness indicates greater physiological impact and resistance to expansion.

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15
Q

How does external pressure affect venous return?

A

External pressure increases limb pressure, facilitating venous return by pushing fluid out of tissues.

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16
Q

What law explains the relationship between tension, radius, and pressure in compression?

A

Laplace’s law

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17
Q

What is the difference between short stretch and long stretch compression bandages?

A
  • Short stretch bandages provide high pressure during movement and low pressure at rest.
  • Long stretch bandages provide mild compression and lower working pressure.
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18
Q

What is the advantage of multi-layer bandages over single-layer bandages?

A

Multi-layer bandages maintain a pressure gradient for a prolonged period and are recommended as first-line treatment for venous leg ulcers.

19
Q

What materials are used in paste bandages like Unna’s boot?

A

Paste bandages use gauze impregnated with zinc oxide, calamine, glycerin, and gelatin, forming a semi-rigid support.

20
Q

What are the characteristics of tubular bandages?

A

Tubular bandages provide graduated compression, but their generic shapes and sizes may not fit all patients and lose compression over time.

21
Q

What is the typical compression provided by compression stockings?

A

Compression stockings typically provide 8–50 mmHg, with pressure greatest at the ankle and decreasing superiorly.

  • Used for long-term management
22
Q

What are Velcro compression garments, and what is their main advantage?

A

- Velcro compression garments are removable orthotic devices that provide sustained compression and are easy to apply.

- Disadvantages

  • High one-time cost
  • Need for patient adherence for daily wear
23
Q

What type of compression bandage is recommended for lymphedema management?

A

Short stretch bandages are commonly used for lymphedema as they work with the calf muscle pump.

24
Q

What are toe wraps, and what condition are they commonly used for?

A

Toe wraps provide compression for localized edema management, especially in toes and feet.

25
Q

What is the difference between flat-knit and circular-knit compression stockings?

A
  • Flat-knit stockings are stiffer and better for lymphedema but more difficult to don.
  • Circular-knit stockings are less stiff and easier to apply.
26
Q

What is the purpose of anti-embolism stockings?

A

Anti-embolism stockings (16-18 mmHg) are used for non-ambulatory patients to prevent deep vein thrombosis and manage edema.

27
Q

How often should compression garments be replaced?

A

Compression garments should be replaced every 3–6 months.

28
Q

When should custom compression garments be used?

A

Custom garments are used when standard sizes do not fit or for patients with unique limb shapes or severe lymphedema.

29
Q

What are the compression levels for managing venous insufficiency and associated edema?

A

Low to moderate compression (25-35 mmHg) is used for edema secondary to venous insufficiency, while moderate to high compression (30-50 mmHg) is for persistent edema or lymphedema.

30
Q

What is the key feature of gradient compression stockings?

A

Gradient compression stockings exert the greatest pressure at the ankle, decreasing as they move upward.

31
Q

Why are donning aids recommended for compression garments?

A

Donning aids make it easier to apply compression garments, especially for patients with limited mobility.

32
Q

What type of compression stockings is suitable for long-term management of venous insufficiency?

A

Knee-high gradient compression stockings are generally sufficient for long-term management.

33
Q

What is the purpose of compression pumps in lymphedema management?

A

Compression pumps remove fluid from the area but do not remove protein, which can lead to fibrosis if not addressed.

34
Q

When are compression pumps recommended as an adjunct to manual lymph drainage?

A

Compression pumps are used when constant compression is not tolerated or manual lymph drainage is unavailable.

35
Q

What are intermittent pneumatic compression devices used for?

A

They stimulate venous return and are typically used for recalcitrant ulcers unresponsive to standard compression therapy.

36
Q

What is the recommended dosage for lymphedema treatment with compression pumps?

A

The recommended dosage is 45–60 minutes at 30–60 mmHg sequential pressure.

37
Q

What is the limitation of compression pumps in long-term edema management?

A

Residual protein after pump use can draw fluid back, necessitating additional treatments like manual lymph drainage.

38
Q

What insurance criteria must be met for intermittent pneumatic compression device coverage?

A

Patients must have a recalcitrant ulcer for over 6 months and have received adequate compression therapy.

39
Q

What patient factors should be considered when selecting a compression product?

A
  • edema presence
  • venous return impairment
  • arterial perfusion adequacy
  • open wounds
  • limb shape
40
Q

How should compression therapy be adjusted for patients with arterial disease?

A

The degree of compression should be modified, with lower levels used to ensure tolerance.

41
Q

Why are leg elevation and calf muscle exercises recommended alongside compression therapy?

A

These interventions enhance venous return and complement the effects of compression.

42
Q

What type of compression is typically used for patients with significant drainage from wounds?

A

Products with absorptive inner layers, such as multi-layer bandages, are used to manage excess wound drainage.

43
Q

Indication / Compression

  • lymphedema = ?
  • Moderate to severe UE lymphedema = ?
  • Moderate to severe LE lymphedema = ?
  • Stage 3 LE lymphedema = ?
A
  • 10–21 mmHg = lymphedema
  • 15–32 mmHg = Moderate to severe UE lymphedema
  • 30–40 mmHg = Moderate to severe LE lymphedema
  • < 40 mmHg = Stage 3 LE lymphedema
44
Q

Pressure vs. Stiffness

A

- Pressure: force that is created by the elastic recoil of the product on the tissue

  • (Dosage (mmHg) / Resting pressure (IP) = Therapeutic Dosage

- Stiffness: force that is created by the resistance to expansion of the product - Currently not stated.
* Higher stiffness greater physiologic impact.

DPT 773 - Integumentary (20 decks)

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