Chronic edema of the lower extremities: international consensus recommendations for compression therapy clinical research trials.
Chronic edema is a multifactorial condition affecting patients with various diseases. Although the pathophysiology of edema varies, compression therapy is a basic tenant of treatment, vital to reducing swelling. Clinical trials are disparate or lacking regarding specific protocols and application recommendations for compression materials and methodology to enable optimal efficacy. Compression therapy is a basic treatment modality for chronic leg edema; however, the evidence base for the optimal application, duration and intensity of compression therapy is lacking. The aim of this document was to present the proceedings of a day-long international expert consensus group meeting that examined the current state of the science for the use of compression therapy in chronic edema. An expert consensus group met in Brighton, UK, in March 2010 to examine the current state of the science for compression therapy in chronic edema of the lower extremities. Panel discussions and open space discussions examined the current literature, clinical practice patterns, common materials and emerging technologies for the management of chronic edema. This document outlines a proposed clinical research agenda focusing on compression therapy in chronic edema. Future trials comparing different compression devices, materials, pressures and parameters for application are needed to enhance the evidence base for optimal chronic oedema management. Important outcomes measures and methods of pressure and oedema quantification are outlined. Future trials are encouraged to optimize compression therapy in chronic edema of the lower extremities.
Breast Care Department, Walter Reed National Military Medical Center, Bethesda, MD, USA.
N
N
Stout
H
H
Partsch
G
G
Szolnoky
I
I
Forner-Cordero
G
G
Mosti
P
P
Mortimer
M
M
Flour
R
R
Damstra
N
N
Piller
M J
MJ
Geyer
J-P
JP
Benigni
C
C
Moffat
A
A
Cornu-Thenard
F
F
Schingale
M
M
Clark
M
M
Chauveau
D002908:Chronic Disease; D002986:Clinical Trials as Topic / Q000379:methods / Q000592:standards*; D032921:Consensus; D003299:Cooperative Behavior; D004487:Edema / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D019317:Evidence-Based Medicine / Q000592:standards; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices / Q000592:standards*; D007391:International Cooperation; D035002:Lower Extremity / Q000098:blood supply*; D012107:Research Design / Q000592:standards*; D053828:Stockings, Compression / Q000592:standards*; D016896:Treatment Outcome