What compression therapy is
Compression therapy for leg wounds in St. Louis is arranged through Gateway when a treating clinician orders it. Compression means steady, measured pressure on the lower leg from wraps, garments or a pump. The pressure helps veins move blood back toward the heart and helps move extra fluid out of the tissue.
When fluid sits in the legs, skin can stretch, weep and break down, and open areas struggle to close. Bringing the swelling down is often a central part of caring for a venous leg ulcer. Our guide on what compression therapy is covers the basics.
Who compression therapy may help
- People with venous leg ulcers, which usually form near the ankle
- People with long-standing leg swelling and fragile, discolored or weeping skin
- People with lymphedema and a wound on the leg or foot
- People whose leg ulcer has closed and who want to lower the chance it returns
Compression is not right for everyone, which is why assessment comes first.
Why circulation is checked before compression
Compression squeezes the leg. If the arteries that carry blood down to the foot are narrowed, that pressure can do harm. Before ordering compression, the treating clinician considers arterial blood flow. They may feel for pulses, look at skin color and temperature, and order a test such as an ankle-brachial index. Read about circulation tests before compression.
The clinician also considers why the leg is swollen. Swelling related to heart failure, kidney disease, a blood clot or infection may call for a different plan or for other treatment first.
What the treating clinician may order
- Multilayer wraps, applied by a trained clinician or nurse and left in place between changes
- Adjustable wraps with fasteners that you or a caregiver can put on and take off
- Compression stockings, often used once a wound has closed or the swelling is controlled
- A pneumatic compression pump for some people with ongoing swelling or lymphedema
- A dressing under the compression to manage drainage
The clinician chooses the type and level of pressure and sets how often wraps are changed. People with both vein and artery disease are sometimes given a lighter level of compression and watched more closely.
How Gateway arranges compression therapy at home
Compression only helps when it stays on and is reapplied on schedule. Gateway schedules the clinician’s visits, follows up on orders for wraps and garments, and helps clarify who applies compression between visits. That may be a home health nurse, a caregiver the clinician has taught, or you.
If your legs need longer-term swelling care, see lymphedema and edema management. Our tips for keeping compression wraps comfortable cover slipping, itching and footwear.
Compression in nursing and assisted living facilities
In a facility, nurses usually apply and check compression under the clinician’s orders. Gateway coordinates visit days with the nursing team, confirms that staff have the current orders, and follows up on supplies so wraps are on hand when a change is due.
Residents with memory loss may pull at wraps or be unable to say that something hurts. Staff and families can tell the clinician, who may choose a different approach.
Working with primary care on leg swelling
Leg swelling often traces back to the heart, kidneys, veins or medications. Your primary care clinician manages those, so the two plans need to match.
Gateway helps make sure the wound clinician’s findings reach primary care, and that news such as a new diagnosis or a hospital stay reaches the wound clinician. Learn more about circulation and vascular health.
Changes to report while wearing compression
Call the treating clinician right away if you notice:
- Toes that turn cold, pale, blue or numb
- New or sharply worse pain in the foot, the calf or under the wrap
- A wrap that has slipped, bunched or rolled into a tight band
- Drainage soaking through the wrap
- Spreading redness, warmth or fever
- New swelling in one leg, especially with pain
Ask ahead of time what to do if a wrap feels too tight, including when it is all right to take it off. Call 911 for chest pain or trouble breathing. Gateway is not an emergency service.
How to start
Call 314-325-0126, or request care and we will call you back. You do not need a referral, and the form asks only for a name and phone number. Visit availability is confirmed by location and care setting.
Facilities and practices can refer a patient or fax a referral to 314-786-7966.
Common questions
Does compression therapy hurt?
Compression should feel snug and supportive, not painful. Some people notice aching in the first days as the swelling comes down. Pain that is sharp, keeps getting worse, or comes with numbness or a color change in the toes is not expected, and you should report it promptly. There are often other wrap types or pressure levels to consider.
Can I shower with compression wraps on?
Most multilayer wraps need to stay dry, and the clinician or nurse will explain how to protect them. Adjustable wraps and stockings can often come off for bathing if your clinician says so. Our guide to showering and bathing with a wound has practical ideas.
Will I need compression after my leg wound heals?
Often, yes. The vein problem that led to the ulcer usually remains after the skin closes, so many clinicians recommend long-term compression stockings to lower the chance of another ulcer. The clinician prescribes the type and strength. Ask how to get fitted, how to put the stockings on and when to replace them.
Can I use store-bought compression socks on a leg with a wound?
Ask the treating clinician first. With an open wound, or when artery disease is possible, the type and strength of compression should be chosen after an assessment. A sock that fits poorly can roll into a tight band and damage skin. Bring the socks you already own to the visit.
Related pages
General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.