Prevention of venous ulceration by use of compression after deep vein thrombosis

Venous ulcers may result from damage to the lining of the veins after an occurrence of deep vein thrombosis (DVT). As the pressure in the damaged venous system remains pathologically high, a result of DVT, swelling develops, hemosiderin staining develops around the ankle area, and varicosities often develop. These symptoms are part of the postphlebitic syndrome and are a precursor to formation of the chronic venous ulcer. The mainstay of treatment or prevention for venous ulcers remains compression therapy. In spite of the evidence that compression is necessary to reduce edema and allow the ulcer to heal, many patients still are not using compression after DVT to prevent ulcer formation. This article describes the prevalence, cost, etiology, and pathophysiology of postphlebitic syndrome and presents the nursing intervention of compression therapy as an ulcer prevention strategy for the patient with DVT. A variety of compression strategies are discussed. A case study of a patient in need of compression therapy is presented. (J Vasc Nurs 2000;18:123-7)