Compression and wound healing

Wound healing is an intricate process of the human body with specific and complex phases to achieve new healthy skin tissue. There are several challenges in completing the healing process; one will require pairing wound care with compression.

Compression as an adjunct therapy to wound care involves the application of pressure to wounds or affected extremities from bandages, wraps, socks, stockings, or compression devices. This pressure is calibrated for what the body requires and also customized for the body’s size or surface area that needs compression. It is controlled compression and when used fittingly, it will be one of the leading factors to help speed up wound healing.

HOW COMPRESSION THERAPY WORKS FOR WOUNDS

1. IMPROVING CIRCULATION

Compression primarily helps with blood circulation in affected areas. With compression, the veins are supported in bringing back deoxygenated blood towards the heart and preventing blood from pooling in the peripheries. This improved blood circulation will help the best healing cells, nutrients, and oxygen to reach the wound site promoting a conducive environment for optimal wound healing. Otherwise, the swelling will only push the skin further away from the blood supply that the wound needs for healing.

2. EDEMA AND SWELLING REDUCTION

Edema or swelling is one of the body’s reactions to wounds due to inflammation or other chronic conditions which then results in poor wound healing. Compression can reduce the edema by removing excess fluids from affected and surrounding tissues. Addressing the swelling also helps with pain and discomfort if any. Edema or swelling will lead to more drainage causing maceration or a too moist wound environment resulting in the increasing size of wounds or the development of new wounds. The internal pressure from swelling can also initiate micro-skin breaks where bacteria can get in and cause an infection.

3. TISSUE OXYGENATION

Basically, all cells will need oxygen to fulfill their duty and that goes without saying that oxygen is critical in wound healing. This is needed to fuel the body’s capability for tissue repair. Compression will increase oxygenation by facilitating blood flow as per the first point, and also reduce oxygen deficiency by compressing tissues, arteries, and veins closer. Sufficient levels of oxygen sustain the development of healthy pink granulation tissue and help fight off bacteria on the wound bed.

Compression therapy can be used on a variety of wound types including but not limited to venous and arterial ulcers, pressure ulcers, and diabetic foot ulcers. Venous ulcers benefit from compression by drawing deoxygenated blood away from the wounds and preventing blood pooling reducing the swelling. Compression can help arterial ulcers get adequate blood supply when used with caution and under the supervision of an expert in treating arterial issues or a vascular doctor. Pressure ulcers, on the other hand, can be helped with compression by reducing the risk of damage while helping oxygen-rich blood flow to the pressure point areas. Lastly, diabetic ulcers benefit from compression with improved circulation, swelling reduction, and tissue oxygenation as diabetic patients are at a higher risk of developing chronic non-healing wounds with concerns for infection. However, the success of compression therapy is subject to an adequate and proper assessment of conditions causing and affecting the wound, accurate selection of the level of compression and device suitable for the patient’s needs and capabilities, and thorough application techniques.

The benefits and considerations accompanying compression therapy can be discussed further in detail in office by Dr. Jenna Wishnew. Dr. Wishnew specializes in wound care and hyperbaric oxygen therapy (HBOT). She serves as the medical director of the wound care and hyperbaric center at Methodist Richardson Medical Center. She compliments her wound care practice with vein and swelling management at Lam Vascular and Associates.

Author

Jenna Wishnew Dr Wishnew is a Board Certified General Surgeon practicing in the North Texas area She specializes in general surgery, gastroparesis, wound care, vein concerns and robotic surgery.