[Value of compression therapy in treatment of deep venous thrombosis]

Therapy in the acute phase of deep vein thrombosis aims to prevent the longitudinal growth of the thrombus as well as the life-threatening complication of pulmonary embolism. Compression therapy is part of all revascularisative and conservative treatment strategies, but hardly mentioned in most of the literature. Clinical efficacy of a sufficient compression therapy in patients with acute deep vein thrombosis is marked by a quick ease of subjective complaints as well as a reduction of the edema. The long-term risk of deep vein thrombosis, the postthrombotic syndrome, is avoidable by the use of compression therapy. Clinical studies about the effectiveness in relation to the length of the thrombus and the incidence of pulmonary embolism are missing as well as studies about the selection of the best compression material. Recently compression pressures were experimentally measured between long and short stretch bandages and the skin in order to select bandage material. It can be concluded that long stretch bandages can be used in the treatment of acute phlebothrombosis in mobile out-patients. Short stretch bandages should be used in immobile patients in order to avoid high pressures between the skin and the bandages. Compression stockings (Class III) represent an equivalent alternative to compression bandages after the resolution of edema.