Although peripheral arterial occlusive disease is not an absolute contraindication, compression therapy can only be administered in this case when the arterial pressure conditions are known. Caution in case of an arterial ankle pressure under 70 mm Hg!
Diabetes patients with medial sclerosis bear a special risk because ultrasound pressure measurements are not indicative in this case. If diabetic neuropathy also exists, the patient does not feel any pain so that also this “warning signal” is missing.
In case of latent heart failure, the sudden increase in the venous return can trigger right ventricular decompensation.
If heart failure does not exist, decongestion of the legs can be achieved by elevating the legs by approx. 30° at intervals. Because a sitting position is generally more disadvantageous than a recumbent one, sitting and recumbent positions should be alternated regularly.
The compression bandage is worn until the leg is decongested or the ulcer is healed and is covered by an intact epidermis. Following the treatment, an individually adequate compression stocking in the appropriate compression class should be worn for after-treatment to prevent the recurrence of backflow disorders.
