Compression therapy for treatment of venous disease and limb swelling

Although compression therapy was initially described over 2,000 years ago (Felty and Rooke Semin Vasc Surg Mar 18:36-40, 1), several patients with edema do not receive appropriate compression therapy. Instead, most patients with edema are treated primarily with diuretics. Compression therapy is the cornerstone of treatment of venous edema and lymphatic disorders. Compression therapy decreases the foot and leg volume and reduces venous reflux and venous hypertension. Compression can be achieved by multiple different modalities, such as inelastic bandages; multilayered wraps; short, medium, and long stretch bandages; graduated compression stockings; and pneumatic compression devices. The major criticism of compression therapy is poor patient compliance. Compliance can be improved by selecting appropriate compression therapy tailored to the needs of the individual patient and by providing adequate patient education.