SG is an employee of SIGVARIS. The feeling that a compression device, MCS, TPS or CB, is ‘too tight’ is often reported by the patient on first application and may influence compliance. Wrap of choice. Lean Library can solve it. Distal foot ulcers in patients with normal arterial circulation have been described as a complication of firmly applied MC bandages.26 Tissue damage has also been described by inappropriate use of or malfunctioning IPC devices.27–30. Very rare but severe adverse events, including soft tissue and nerve injury, were also identified. In some centres, compression is used immediately upon resolution of the fever and systemic infection symptoms.78,84 However, compression needs to be made comfortable if the tissues remain tender. lateral pressure on toes with interdigital maceration), we suggest a modification of compression. These include severe PAOD, compression of epifascial arterial bypasses, severe cardiac insufficiency and true allergy to compression material. The outer bandages used for lymphedema wrapping may looklike the ordinary ACE-type bandages available at any drug store, but they're not the same. Because of a tourniquet effect, improper compression can cause local SVT, especially in combination with prolonged sitting (long-haul flights). fibular head) mainly in cases with excessive local compression pressure, e.g. Oedema or venous ulcerations may occur or persist after arterial bypass surgery or arterial stenting. Complete Decongestive Therapy (CDT) involves manual lymph drainage (MLD) & compression bandaging (as well as skin care & exercise). The Criteria Committee of the New York Heart Association. Nick Morrison https://orcid.org/0000-0002-1750-6521, Giovanni Mosti https://orcid.org/0000-0001-7639-8463, Christopher R Lattimer https://orcid.org/0000-0002-0282-4826. Summary of reported adverse events. SW reports she does not have any conflicts to disclose. Medical compression (MC) devices, including MC stockings (MCS), compression bandages (CB), adjustable compression wraps (ACW) and thromboprophylactic stockings (TPS) are basic management options for the non-invasive treatment of venous and lymphatic diseases. I have also been sent home with a pump and told to pump for 2 hours a day. Peripheral nerve injury caused by misuse of elastic stockings, Peroneal nerve palsy after compression stockings application, Common peroneal nerve palsy caused by compression stockings after surgery, Common peroneal nerve palsy as a possible sequelae of poorly fitting below-knee thromboembolic deterrent stockings (TEDS). due to ill-fitting MCS, TPS or CB. Bacterial colonisation of the skin and chronic venous leg ulcers (VLU) is common and, in the absence of clinical signs of systemic infections, is often treated with topical antiseptics, dedicated dressings and necrotic tissue debridement. NM reports grants from Medi and Medtronic, and personal fees from Medtronic and Merz outside the submitted work. Nomenclature and criteria for diagnosis of diseases of the heart and great vessels. According to national and international guidelines, decompensated cardiac insufficiency is considered to be contraindicative for phlebological and lymphological compression bandaging, MCS and manual lymphatic drainage.44–46, A recent review of 20 international guidelines and consensus papers published between 2009 and 2016 on venous ulcer concluded that only pulmonary oedema should be regarded as a contraindication for compression treatment.47, The results of studies on the redistribution of regional blood volumes by applying compression to the legs of patients in supine position with the help of inflatable rubber boots indicated a reduction in blood volume in the legs and an increased blood volume in the organs of the thorax, abdomen and the liver.48 Similar blood-volume shifts in the legs were identified when classes I and II MCS (18–32 mmHg) were worn on the lower legs.49 Due to the elastic properties of the lower vena cava and the large number of visceral veins, only a fraction of the blood displaced from the legs reaches the right atrium.