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Neue Aspekte der Kompressionstherapie

New aspects of compression therapy

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Zusammenfassung

In diesem Übersichtsartikel werden die Wirkmechanismen der Kompressionstherapie zusammengefasst sowie ein Überblick über Kompressionsmaterialien geboten, zusammen mit einigen praktischen Hinweisen darauf, wie und wann diese Materialien angewandt werden sollen.

Einige neue experimentelle Befunde zur optimalen Dosierung (= Kompressionsdruck) bezüglich einer Verbesserung der venösen Hämodynamik und einer Reduktion von Ödem werden diskutiert. Es wird gezeigt, dass steifes, unnachgiebiges Material bei adäquatem Druck bessere hämodynamische Effekte bewirkt als elastisches Material, und dass relative niedrige Drücke ein Ödem reduzieren können. Eine Kompression der Wade ist für einen Anstieg der Wadenpumpe wichtiger als ein graduiert abgestufter Druckverlauf. Bei Patienten mit gemischten, arteriell-venösen Ulzera und einem Knöchel-Arm Index über 0,6 können unelastische Verbände, die einen Andruck von 40 mmHg nicht übersteigen, die arterielle Durchblutung erhöhen und die venöse Pumpfunktion verbessern.

Summary

In this review article the mechanisms of action of compression therapy are summarized and a survey of materials is presented together with some practical advice how and when these different devices should be applied. Some new experimental findings regarding the optimal dosage (= compression pressure) concerning an improvement of venous hemodynamics and a reduction of oedema are discussed. It is shown, that stiff, non-yielding material applied with adequate pressure provides hemodynamically superior effects compared to elastic material and that relatively low pressures reduce oedema. Compression over the calf is more important to increase the calf pump function compared to graduated compression. In patients with mixed, arterial-venous ulcers and an ABPI over 0.6 inelastic bandages not exceeding a sub-bandage pressure of 40 mmHg may increase the arterial flow and improve venous pumping function.

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Authors and Affiliations

  1. Praxis, Martinstr.1, 1180, Wien, Österreich

    Bernhard Partsch

  2. emeritierter Vorstand der Dermatologischen Abteilung des Wilhelminenspitals, Medizinische Universität Wien, Wien, Österreich

    Hugo Partsch

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  1. Bernhard Partsch
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  2. Hugo Partsch
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Correspondence to Bernhard Partsch.

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B. Partsch und H. Partsch geben an, dass kein Interessenkonflikt besteht.

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Partsch, B., Partsch, H. Neue Aspekte der Kompressionstherapie. Wien Med Wochenschr 166, 305–311 (2016). https://doi.org/10.1007/s10354-016-0467-9

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  • DOI: https://doi.org/10.1007/s10354-016-0467-9

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