Whilst not reported as a complication and reversible, it may represent the physical evidence of why compression devices may cause discomfort or irritation.Ĭlassical compression devices apply low or no pressure to the flat dorsum of the forefoot and toes.

It is manifest as circumferential red lines or a patch of redness, typically over fulcrum areas, where the fabric of the material rubs against the skin. Tension-induced skin stress is a frequent experts’ observation occurring in patients after a well applied bandage or measured stocking has been removed. 4 Delayed bandage changes are contributory, as these prolong contact with irritant topical applications on pre-sensitised skin of venous disease patients. A considerable number of potentially treatment-related adverse events, including irritant inflammatory skin reactions below four-layer bandage systems and short-stretch bandaging, has been described in a Canadian trial. Skin irritation may be mistaken for allergic reactions, but usually they are self-limiting, can be controlled without interruption of the compression treatment and may be prevented through adequate skin care. 2, 3 The higher incidence of itching and dryness reported with MCS when compared with TPS may be partially explained by the skin of MCS patients already being compromised due to venous congestion. Low-severity skin problems, including itching, feeling cold or warm and dry skin, are frequently associated with compression therapy.

For example, in a patient with severe peripheral arterial occlusive disease (PAOD) with an ankle pressure of 60 mmHg for whom a contraindication for MCS exists, well-padded inelastic CB applied with low pressure may be appropriate even with an ankle pressure of 50 mmHg. Many of the reported risks are similar in MCS and CB but there are also some considerable differences. The use of compression therapy must be considered carefully in the presence of such conditions, and contraindications must be considered. Therefore, every patient receiving compression therapy should be screened for conditions that increase the risk of complications, and every compression device should be checked for appropriate fit and application. All of the more severe complications are very rare and occur in predisposed patients or during improper use of compression therapy. This paper reviews common risks and complications of compression therapy reported in literature ( Table 1), including skin irritation and pruritus, rare complications such as superficial venous thrombophlebitis at the upper stocking border, decompensation of heart failure or spread of bacterial and/or fungal infection, and exceptional but potentially devastating complications such as nerve damage, venous thromboembolism, arterial thrombosis and skin or limb necrosis. Risks and complications for compression therapy reported in literature

Negative man without bandages