Dissemond J, Eder S, Läuchli S, Partsch H, Stücker M, Vanscheidt W
Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstraße 55, 45122, Essen, Deutschland.
Klinik für Gefäßchirurgie und Gefäßmedizin, Schwarzwald-Baar-Klinikum, Villingen-Schwenningen, Deutschland.
Med Klin Intensivmed Notfmed. 2018 Oct;113(7):552-559. doi: 10.1007/s00063-016-0254-9. Epub 2017 Jan 11.
Compression therapy is the basis for successful treatment in most patients with venous leg ulcers. Concerning compression therapy, the initial phase of decongestion and the following phase of maintenance should be differentiated. While in the maintenance phase (ulcer) stocking systems are now frequently recommended, in the decongestion phase compression bandages are mostly still used, which however are often inappropriately applied. In German-speaking countries, compression therapy with short-stretch bandages has a long tradition. However, their correct application requires good training and monitoring, which is often lacking in daily practice. Less error-prone treatment alternatives are multicomponent systems, some of which have an optical marker for the control of the correct subbandage pressure. In another new type of compression system, which is called adaptive or wrap bandages, the compression pressure can be adjusted using a Velcro fastener. Accompanying intermittent pneumatic compression therapy can also be used in the decongestion phase. Thus, there are now several different treatment options that can be used for the decongestion phase in patients with venous leg ulcers. Often bandages with short-stretch materials are very prone to errors and should in most cases be replaced by other compression systems today. The patient's preference, need, and capability should be considered when selecting the appropriate system for the individual patient.
压力治疗是大多数下肢静脉溃疡患者成功治疗的基础。关于压力治疗,应区分初始的消肿阶段和后续的维持阶段。在维持阶段(溃疡期),现在经常推荐使用弹力袜系统,而在消肿阶段,大多仍使用压力绷带,但压力绷带的应用常常不当。在德语国家,使用短拉伸绷带进行压力治疗有着悠久的传统。然而,正确应用短拉伸绷带需要良好的培训和监测,而日常实践中往往缺乏这些。出错几率较小的治疗选择是多组件系统,其中一些带有光学标记,用于控制正确的子绷带压力。在另一种新型的压力系统中,即自适应或包裹式绷带,可以使用魔术贴调整压力。在消肿阶段也可同时使用间歇性气动压力治疗。因此,现在有几种不同的治疗选择可用于下肢静脉溃疡患者的消肿阶段。短拉伸材料的绷带往往很容易出错,如今在大多数情况下应被其他压力系统取代。为个体患者选择合适的系统时,应考虑患者的偏好、需求和能力。