Tutorial 6

Question 1

What are some conservative intervention options?

Answer 1

• Compression therapy (bandaging, garments)
• Wound management
• Massage
• Skin care
• Positioning and elevation
• Exercise and movement

Question 2

Role of compression therapy

Answer 2

1. Enhance muscle pump function to increase fluid flow to heart
2. Increase total fluid pressure within tissues to encourage drainage of fluid out of tissues and prevent fluid drainage into tissues
3. Reduce stretched and dilated vessels
4. Improve valve function
5. Maintain and improve limb shape
6. Limb protection

Question 3

Reasons to not use compression

Answer 3

• Systolic ankle pressure below 50-80 mmHg
• Arterial disease symptoms
• Cardiac failure
• Neuropathy
• Social circumstances

Question 4

What do we need to know about level and granulation of compression?

Answer 4

• Pressure applied is granulated

- Level of compression being applied

Question 5

Law of LaPlace

Answer 5

Pressure = Tension / Radius of Curvature

Question 6

What is tension measured in?

Answer 6

% stretch or grams/inch

Question 7

What is radius curvature?

Answer 7

Of the limb

Question 8

What are the phases of compression bandaging?

Answer 8

• Reduction

- Maintenance

Question 9

What can you control in the reduction phase of compression bandaging?

Answer 9

• Bandage technique (spiral vs figure 8)
• Amount of bandage overlap
• Number of bandage layers
• Use of padding
• Spot pressure

Question 10

What does the degree of compression applied by bandage depend on?

Answer 10

• Physical and elastomeric bandage properties (high vs low stretch)
• Size and shape of limb
• Bandage technique and skill of application
• Physical activity with bandage

Question 11

What happens in the maintenance phase of compression bandaging?

Answer 11

• Prescribe and measure when oedema reduced or plateaued
• Need to consider:
  >level of compression required
  >style of garment for condition and location
  >effective control
  >type of material and manufacturer
  >cost of garment
  >donning

Question 12

What is retrograde massage and where is it used?

Answer 12

• Tissue compression distal to proximal - affected area
• Dependency oedema
• Acute oedema
  UPPER LIMB

Question 13

What is lymphatic oedema and where is it used?

Answer 13

• Tissue compression proximal to distal
• Direction of fluid around damaged lymphatics
• Development of collateral vessels
  UPPER & LOWER LIMB

Question 14

What is scar massage

Answer 14

Manipulation of skin and underlying tissues

Question 15

What is the benefit of skin care?

Answer 15

• Moisturisers can assist with skin hydration
• Reduction of itch
• Skin softening
• Prevention of tears