Compression bandage

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A compression bandage is a bandage made of elastic bandages that is placed on the legs. It improves the pumping function of the veins and increases the outflow of blood and lymph fluid. Read about when to apply a compression bandage.

What is a compression bandage?

A compression bandage is a wrap bandage that is placed around the leg with elastic bandages. It supports the return flow of blood from the deep leg veins to the heart. The absorption of tissue fluid into the lymph vessels is also promoted by the compression bandage. A distinction is made between different techniques for compression therapy:

Compression according to Pütter
Fischer compression
Compression with an ear of corn bandage

A compression bandage can be put on by both the doctor and appropriately trained nursing staff.

When do you put on a compression bandage?

Compression bandages are generally applied after operations, for example, to prevent water retention (edema) and blood clots (thrombosis). It is used in the following constellations:

Fluid build-up in the tissue (edema)
Varicose veins
Chronic venous insufficiency
Thrombophlebitis (inflammation of the veins with the formation of blood clots)
Prevention of blood clots
Condition after blood clots in the deep veins of the legs
Lower leg ulcer (ulcus cruris, "open leg")

A compression bandage must not be used if the pressure exerted by the bandage on the tissue could result in insufficient blood flow. This risk exists, for example, in patients with peripheral arterial occlusive disease (PAD) or cardiac insufficiency (decompensated heart failure). A compression bandage is also not advisable in the case of vein occlusions or severe touch disorders.

Compression bandage or compression stocking?

Both the compression bandage and the compression stocking promote the return flow of venous blood and lymph fluid from the legs to the trunk. With the compression bandage, swollen legs can initially be decongested, as it adapts to the current state of swelling of the leg with each wrap. The compression stocking can be put on more easily, also by the patient himself. The stocking is therefore often used in long-term therapy.

What do you do with compression therapy?

First, the patient undresses so that the legs can be treated and lies on his back. The doctor now lifts the leg and bends the patient's foot in the ankle by 90 °.

Compression bandage: Pütter's wrapping technique

The doctor now begins to apply the bandage and wraps the first bandage around the forefoot just below the toes, starting from the inside out. The toes remain free so that the doctor can check whether they have adequate blood flow. Then the foot and lower leg are wrapped all around in an ascending manner. At knee level, the doctor fixes the bandage with a strip of plaster so that it does not slip when moving, and wraps a second cloth bandage from the outside of the ankle in the opposite direction to the first bandage upwards. Here, too, the end is fastened with a plaster strip or a staple. The Pütter compression bandage only covers the foot and lower leg, but the thigh can also be included. To do this, the doctor wraps two or three more bandages around the thigh from the knee up to the groin.

Compression bandage: Wrapping technique according to Fischer and Corn Ear Association

With the Fischer wrapping technique, the cloth bandages are placed around the leg in a strictly spiral shape, while with the corn-ear bandage, the bandages run around the leg in an eighth shape.

Apply compression bandage correctly

Basically, a compression bandage should be applied according to the following pattern:

The individual bandages must overlap and should be wrinkle-free.
The ankle should be positioned at right angles.
The pressure of the cloth bandages should decrease from the foot to the knee.
The bandage must not cause any pressure points, lacing or pain.
The heel should be covered.
Sensitive parts of the body, such as protruding bones, should be adequately padded with cotton.

What are the risks of a compression bandage?

If the bandage is applied too tightly, the blood supply to the leg is poor and tissue can die (necrosis). In addition, pressure damage can occur to nerves. Disorders of touch, numbness or painful tingling are the result. To avoid complications, the doctor regularly checks the bandage.

What do I have to consider with a compression bandage?

When applying the compression bandage, you should already pay attention to whether the bandage is pressing, cutting or causing pain. To do this, walk around for a while and then check again whether the bandage has slipped or is wrapped too tightly. Watch out for tingling or numbness - these can be a sign of insufficient blood flow to the leg. If you have any complaints, you should inform your doctor as soon as possible. If the swelling of the leg has subsided over time, the doctor can prescribe custom-made compression stockings instead of the compression bandage.

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