Pneumatic Compression Pump Therapy:
March 17, 2008
An Evidence-based Approach to the Treatment of
Chronic Vascular Disorders
Teresa Conner-Kerr, PT, PhD, CWS, CLT
The importance of compression therapy in treating tissue swelling associated with lymphedema and venous insufficiency is well recognized by wound management practitioners. Compression therapy is delivered by a variety of methods with differing levels of evidence to support the use of specific compression modalities. Treatment algorithms prepared by experts from a variety of disciplines using original research are available that provide evidence ratings for particular compression modalities.1,2
In The Venous Ulcer Guideline developed by the Government and Regulatory Task Force of the Association for the Advancement of Wound Care, an “A” level of evidence was assigned to eight different compression therapy options.2 One of the eight therapeutic modalities receiving an “A” level rating was intermittent pneumatic compression.
Pneumatic compression pumps have been in use since the 1960s for the treatment of limb swelling due to both acute and chronic conditions. Pneumatic compression pumps consist of an electric pneumatic pump that is used to push compressed room air into an inflatable garment or sleeve either continuously or intermittently depending on inflation and deflation times. Most pneumatic compression pumps today use intermittent compression cycles with inflation and deflation cycles either preset or programmable by the clinician. The sleeve or garment may have a single chamber design with one port or a multiple chamber design with one port per chamber. Pressure may be graded with the highest pressures in distal chamber segments. Depending on the specific manufacturer, compression cycles, treatment times, and compression levels may be either preset or programmable. Multichamber sequential compression pumps typically provide the greatest programming flexibility. Newer compression pump technology such as the Lympha-pants™ (LymphaCare, New York, NY) employs large multi-segment chambers that cover bilateral limbs and the lower or upper trunk simultaneously so that a comprehensive treatment may be delivered in a more efficient manner. The sequential inflation of chambers from distal to proximal in these devices is also thought to more naturally mimic lymph return.
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