Compression therapy in the management of varicose veins

In the management of patients with chronic venous disease (CVD), compression therapies, in the form of stockings, wraps, and/or bandages, are an indispensable treatment option. Used as both primary therapy and adjunct before and after venous interventions, the aim of compression therapies is to provide support to the calf muscle pump and to reduce venous hypertension in the lower limbs.1 On a macroscopic level, additional pressure provided by compression improves venous and lymphatic return, augmenting that which is already provided by the calf musclepump system.2 Graduated compression also has effects on microscopic changes related to CVD. Compression has been shown to reduce the levels of inflammatory markers found in the systemic circulation and plays a role in improving microcirculation within the skin, improving tissue oxygenation, and reducing the level of several cytokines which may help with preventing skin breakdown as well as with healing of venous leg ulceration.3–6 As shown in several studies, the use of compression treatment is also effective in the management of CVD symptoms including swelling.7 This one-page guideline from the International Union of Phlebology aims to highlight the use of compression therapy in the management of varicose veins. It summarises the indications for compression therapy and key clinical considerations that allmedical professionals should remember when managing patients presenting with symptomatic CVD.