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Evidenz der Kompressionstherapie

Evidence of compression therapy

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Zusammenfassung

Hintergrund

Der Einsatz von medizinischer Kompressionstherapie in der Therapie phlebologischer Krankheitsbilder findet breite Anwendung. Mehrlagen- und Mehrkomponentenkompressionsbandagen und medizinische Kompressionsstrümpfe bewirken die Entstauung der Extremität und bessern die klinische Symptomatik. Es wird die Evidenz für den Einsatz der medizinischen Kompressionstherapie bei chronischer venöser Insuffizienz, bei entzündlichen Dermatosen und nach phlebochirurgischen Eingriffen und Interventionen aufgezeigt.

Material und Methoden

Die Übersichtsarbeit gibt eine systemische Darstellung des evidenzbasierten Einsatzes von Kompression. Aktuelle Literatur, insbesondere Leitlinien wurden durchsucht und die Indikationen für die Kompressionstherapie dargestellt.

Ergebnisse

Es besteht eine hohe Evidenz in der Therapie des Ulcus cruris venosum und in der Prophylaxe des Ulkusrezidivs. Der Einsatz nach interventionellen und operativen Eingriffen am Venensystem ist gängige Praxis, die Wirksamkeit kann jedoch nicht durch Studien belegt werden. Ebenso auf Empirie, nicht durch Studien untermauert, basiert die Anwendung der Kompression bei kutanen entzündlichen Erkrankungen wie Erythema nodosum, Pyoderma gangraenosum, Necrobiosis lipoidica, kutane leukozytoklastische Angiitis und Psoriasis der Extremitäten.

Abstract

Background

Medical compression therapy is widely used to treat phlebologic diseases. Compression bandages as well as compression stockings are used. Compression has been identified to be an effective conservative therapy for the healing of venous ulcers and other indications. Thus, the evidence for the use of medical compression therapy and for which indications is presented.

Materials and methods

Review and systematic presentation of the evidence-based use of compression. The current literature, guidelines, and consensus statements were searched and the indications for compression therapy are presented.

Results

There is a high level of evidence that compression therapy is effective to heal venous ulcers and to prevent recurrent ulcers. The use of compression bandages and hosiery after interventional and surgical procedures for varicose veins is based on experience but not on randomized controlled trials. According to clinical experience, the healing of inflammatory skin diseases (e.g., erythema nodosum, pyoderma gangrenosum, necrobiosis lipoidica, cutaneous leukocytoclastic vasculitis, and psoriasis of the extremities) is supported by compression therapy. Compression therapy in patients suffering from venous ulcers is highly recommended.

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Authors and Affiliations

  1. Klinik- und Poliklinik für Haut- und Geschlechtskrankheiten, Universitätsmedizin Greifswald, F.-Sauerbruchstr., 17475, Greifswald, Deutschland

    W. Konschake &  M. Jünger

  2. Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt/M., Deutschland

    E. Valesky

  3. Klinik für Dermatologie, Klinikum Lippe GmbH, Röntgenstr. 18, 32756, Detmold, Deutschland

    H. Stege

Authors
  1. W. Konschake
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  2. E. Valesky
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  3. H. Stege
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  4. M. Jünger
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Corresponding author

Correspondence to M. Jünger.

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Interessenkonflikt

W. Konschake, E. Valesky, H. Stege und M. Jünger geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Konschake, W., Valesky, E., Stege, H. et al. Evidenz der Kompressionstherapie. Hautarzt 68, 625–631 (2017). https://doi.org/10.1007/s00105-017-3999-z

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  • DOI: https://doi.org/10.1007/s00105-017-3999-z

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