Intermittent pneumatic compression in immobile patients.

The purpose of this study is to stress the value of using intermittent pneumatic compression (IPC) in immobile patients. The use of IPC helps prevent limb oedema and the associated skin changes frequently seen on the legs of the immobile patient. Oedema formation is caused by an increase of fluid extravasation, while skin changes including leg ulcers are mainly because of a deficiency of the venous and lymphatic pumps. Conventional compression stockings and bandages impede leg swelling but are less efficient in supporting the deficient veno-lymphatic pump when patients are unable to move. In this situation, actively compressing the limb using IPC is a very meaningful and effective treatment option. Because of a lack of literature on the specific indication of IPC in immobile patients, experimental studies and randomised controlled trials in similar situations are reviewed. IPC is a very effective although underused treatment modality, especially in immobile, wheelchair-bound patients. By inflation and deflation of the air-filled garments, IPC produces cycles of pressure waves on the leg, thus mimicking the working and resting pressures applied by compression bandages. IPC not only reduces leg swelling but also augments the veno-lymphatic pump, which is essential for the restoration of the damaged microcirculation of the skin.