PTA 110 Compression 2

Compression

Application of a mechanical force to increase external pressure on the body or body part.

What does compression increase

fluid balance

How does compression improve fluid balance

increasing hydrostatic pressure in the interstitial space so that it is greater in the vessels

What does compression allow for

circulation rather than accumulation in the periphery

What can compression be

static or intermittent

What are the effects of Effects of External Compression

Improved venous and lymphatic circulation

Intermittent compression may improve what

circulation more effectively than static

Improving circulation may decrease what

edema, prevent the formation of DVT’s, and facilitate healing of venous stasis ulcers

What can Compression garments or bandaging provide

form to new tissue formation

Why is compression useful

over residual limbs, burn-damaged skin, or swollen limbs

Increased temperature increases activity of what

collagenase, which controls scar formation

Indications for External Compression

Edema, Deep Venous Thrombosis, Venous Stasis Ulcers, Residual limb shaping, Control of hypertrophic scarring

What is Edema due to

venous insufficiency

Edema Caused by lack of

physical activity, dysfunction of venous valves, obstruction of the veins by a tumor or inflammation

Most common cause of venous insufficiency is

phlebitis (thickening of vessel walls)

Circulation of deoxygenated blood out of veins is

reduced

What does Elevated venous pressure cause

increase in the amount of fluid in the extravascular space leading to edema

What does the lymphatic system consists of

vessels and nodes through which fluid flows

Nodes are found mostly in what

axillary, throat, groin, and paraaortic areas

Decreased levels of plasma proteins cause

fluid to accumulate in the extravascular space because the osmotic pressure that normally keeps fluid in the lymphatic vessels and veins is reduced

Primary lymphedema is caused by what

a congenital disorder of the vessels

Secondary Lymphedema the flow is impaired by what

blockage or insufficiency of the lymphatics

Adverse effects of Edema

Pain, decreased ROM, and functional limitations

What is there an increased risk of with edema

Increased risk of infections

What does Chronic venous insufficiency cause

itching due to stasis dermatitis and brown pigmentation of the skin

extravascular hydrostatic pressure and circulation

causes fluid to flow out of the vessels into the extracellular spaces

Compression increases extravascular hydrostatic pressure and circulation, which may help with what

move fluid proximally through the vessels to reduce distal edema

EVT

blood clots in the deep veins

Compression decreases clot formation by

improving venous flow and thus reducing venous stasis

What are the uses of compression

Prevention of Deep Vein Thrombosis, Venous Stasis Ulcers, Residual Limb Shaping, Control of Hypertrophic Scarring

Areas of tissue breakdown that occur secondary to

impaired circulation

Compression improves

venous circulation, increases oxygen to tissues, alters white cell adhesion, and decreases edema

What does Residual Limb Shaping help prepare the limb for

prosthetic fitting by decreases swelling and creating a conical shape

Control of Hypertrophic Scarring Most commonly occurs with what

burns

burns Treatment is initiated once when

new epithelium has formed and is continued for approximately 8-12 months

What is Compression is applied with

elastic bandages, self-adherent wraps, tubular elastic cotton supports, or custom-fit garments

How much pressure is maintained during compression

20-30mmHgComplic

Complications for compression

skin irritation, and restriction of ROM

What are the Contraindications for compression

Heart failure or pulmonary edema, Recent or acute DVT, thrombophlebitis, or pulmonary embolism, Obstructed lymphatic or venous return, Severe peripheral artery disease or ulcers caused by arterial insufficiency, Significant decrease in protein levels (less than 2 g/dl)

What are the precautions for compression

Impaired sensation or mentation, Uncontrolled hypertension, Cancer, Stroke or significant vascular insufficiency, Superficial peripheral nerves

Increase edema and worsen condition- ex using compression of a patient with CHF increases what

fluid build up

If too much pressure is applied the device may act as what

tourniquet and impair arterial circulation

Changes in blood pressure and edema levels should be closely monitored when

using compression

Treatment of edema or venous stasis ulcers: inflation is

80-100 seconds

Treatment of edema or venous stasis ulcers: deflation is

25-50 seconds

Residual limb reduction: inflation is

40-60 seconds

Residual limb reduction: deflation time is

10-15 seconds

For all indications, pressure is generally between

30 and 80 mmHg or just below the patient’s diastolic blood pressure

When Should A patient’s blood pressure be measured

before, during, and after the administration of compression

Treatment should be discontinued if what

systolic or diastolic pressure exceeds limits set by the MD