A common challenge faced in the medical field is finding the cause of an individual’s limb swelling. Any limb swelling may be your body’s red flag to a potential underlying condition. When swelling in a limb becomes chronic, pinpointing the origin is vital to getting proper treatment. Some of the most common diagnosis are venous insufficiency and lymphedema. Fluid accumulation can cause painful swelling, non-healing wounds, heaviness, and discomfort decreasing your mobility. Recent studies show that nearly 7 million people in the United States suffer from venous disease. While 2 to 3 million Americans suffer from secondary lymphedema.

CHRONIC VENOUS INSUFFICIENCY

Chronic venous insufficiency (CVI) is when blood is unable to circulate from the lower limbs back to the heart. CVI is caused by incompetent valves and venous hypertension, in both parts of your venous system. The venous system is comprised of two parts, deep circulation and superficial circulation, which are interconnected by perforating veins. Your venous system is an important component to delivering blood to the heart, then passing it through the lungs to obtain oxygen. The oxygenated blood is then delivered to the lower limbs.

VENOUS HYPERTENSION

Venous hypertension leads to secondary lymphedema from the lymphatic system’s inability to keep up with an abnormally high demand of protein-rich fluid. Lymphedema is chronic swelling from protein-rich fluid accumulation in the tissue. Lymphedema occurs secondary to CVI when the lymphatic system is obstructed causing damage, blockage, or abnormal development. Primary lymphedema can be hereditary or congenital, where an individual is born with a compromised lymphatic system.

INTERRUPTED FLOW

Once your circulatory system has been obstructed leading to venous insufficiency or lymphedema, this may lead to an interruption in the venous and lymphatic flow. Both diseases are manageable and treatable.

Risk factors may include:

• Chronic swelling of a limb
• Skin changes such as discoloration or hardening
• Family history
• Invasive surgical procedure i.e. radical cancer surgery
• Chronic open wounds
• Decreased mobility
• Infections such as cellulitis/lymphangitis

MANAGEMENT & PREVENTION

Understanding the ongoing management of both venous insufficiency and lymphedema are important in preventing irreversible damage to the body. Compression therapy, along with proper nutrition a healthy diet and exercise, are the foundation of a treatment plan. Compression stockings are often difficult to get on with little results for chronic swelling. Diuretics may be harmful for long term treatment. Compression devices are widely recognized and highly effective treatment. This is a safe and effective way to assist your body’s circulatory system in moving the excess fluid which has accumulated in the limb. A pneumatic compression device mimics the muscle contraction that naturally occurs when performing a cardiovascular activity. The compression pump is approved by Medicare and covered by many commercial insurers.

Acute Wound Care is a highly focused local provider for at-home compression device treatment for Venous Insufficiency & Lymphedema and wound products. They are licensed with Medicare and HQAA accredited. The specialists at Acute Wound Care work with your treating physician to ensure the device is medically necessary and also handle all of the insurance processing to receive coverage.

“People would see the swelling in my hand and arm and say ‘Oh my God,’” says Naples resident Paul Borsari. Borsari is living with chronic lymphatic leukemia, which caused severe swelling in his arm, and lymphedema.

Lymphedema is a condition in which excess lymph fluid collects in tissue, most often in the legs and/or arms. The fluid causes swelling and if left untreated often causes changes in the skin, even wounds. There are different causes of lymphedema, one can be hereditary or genetic where the individual is born with a compromised lymphatic system. The other is the result of a surgically invasive procedure that may obstruct the lymphatics, and it may result secondary to venous insufficiency.

The severe swelling makes it hard for patients to bend their limbs, complete regular tasks, and can be painful.

COMPRESSION THERAPY

Compression stockings are often used to aid circulation and help reduce swelling, but they don’t always solve the problem, according to Alyssa Parker, Clinical Administrator at Acute Wound Care. The company provides patients with in-home compression pumps that have shown great success in boosting circulation and reducing swelling in both the upper and lower extremities.

In Borsari’s case, he first tried a compression sleeve, then 15 rounds of therapy involving massage and compression wraps.

Following a hospital stay, he was sent home with physical therapy. It was the Lymphedema therapist who connected him with Acute Wound Care. Before long Borsari had an in-home, hospital grade compression pump and was able to successfully manage his lymphedema on his own schedule.

Parker says, “Compression pumps have been around for decades. Many doctors know about their use in hospitals to help with blood clots, but they are unaware of the availability of the treatment for in-home use.”

The pumps sleeves fit from the foot to the groin or the hand to the shoulder. They contain multiple chambers that fill with air in a sequential motion, replicating the circulatory system and assisting blood flow from the extremities back to the heart.

The excess fluid in the limbs is worked back through the circulatory system where it can be naturally eliminated by the body.

HEALING WOUNDS

Compression pumps are not only used to treat lymphedema but are also helpful for patients who have venous insufficiency, chronic edema, poor circulation and ongoing open wounds.

Parker became interested in lymphedema through a research project conducted on the predisposition of the condition in college, later working with patients directly in the treatment of the disease. She says, “A lot of people are misdiagnosed and are not being treated effectively.”

Then there are the wounds. She says, “In some cases, we get patients that haven’t had success healing a wound in months to a year. With the right treatment and specialty dressings, our goal is to get the wound healed within 45 days.”

It’s hard for wounds to heal when the body has poor circulation. Parker says, “It’s important to use proper dressings along with compression when needed. Individuals trying home remedies to heal a wound without proper dressings are at a higher risk of infection which may lead hospitalization.”

SEEING RESULTS

Once Borsari got a compression pump to aid in his circulation, he saw results almost immediately. He says, “It feels like a massage, like someone is hugging your arm.” He uses it at least once a day for an hour explaining, “I’m gonna watch Wheel of Fortune and Jeopardy anyway, so why not do something else while I’m sitting there.”

After suffering with the unsightly swelling for years, he says, “My arm looks great, my wrist is a normal size, and I can see the veins in the back of my hand again.”

About his experience with Acute Wound Care, Borsari says, “My therapist was unbelievable. She was so thorough and taught me techniques for how to use the machine. I was so impressed by her professionalism.”

The compression pumps are portable so patients can travel with them. However, Parker says, “A prescription is needed for the machine. Many insurance carriers cover the treatment. The specialists at Acute Wound Care handle the entire process.”

Borsari says, “I recommend this treatment to everybody and anyone who has this disease. I’m back to playing golf again. I’m back to normal. I feel great!”

Swollen legs are nothing new to Martina*, 72. She’s had them for nearly 50 years. It’s a problem that started when she had her second child. She went to numerous doctors and tried various treatments over the years but found little relief. Martina’s (alias) leg swelling from venous disease and lymphedema was treated with a compression pump from Acute Wound Care in Bonita Springs.

“I’m on diuretics and have been for a very long time,” Martina shares. “I tried compression hose, which really didn’t do anything. I still had swelling and discomfort, which rated a nine on a scale of one to ten.”

One of the causes of Martina’s leg problem is a condition called venous insufficiency. This occurs when the tiny valves in the leg veins that keep blood flowing in one direction – toward the heart – begin to fail. As a result, blood refluxes backward and pools in the legs, causing swelling and pain. Making matters worse, Martina also suffered from lymphedema, or excess fluid in her lymph vessels. Lymphedema also results in swelling of the limbs.

When treatment for Martina’s venous insufficiency provided only limited relief from her leg swelling, her vein specialist recommended a compression pump from Acute Wound Care. Acute Wound Care is a fully accredited home medical equipment provider specializing in hospital-grade compression devices and specialty wound-care dressings.

Two-Way Treatment

Like many patients referred to Acute Wound Care for compression pumps, Martina had already exhausted most conservative options for the treatment of swelling from venous insufficiency and lymphedema, notes Alyssa Parker, certified compression therapist with Acute Wound Care.

“Even after methods such as elevating her legs and wearing the hose, Martina still had symptoms of chronic fluid accumulation and heaviness in her legs,” Alyssa reports. “In Martina’s case, not only will the compression pump relieve these symptoms, it will also prevent progression of her venous disease and lymphedema.

“Our easy-to-use compression pumps remove fluid that has accumulated in the legs or arms. The pump’s limb-sized sleeves gently massage the limb, draining any excess fluid back into the body’s circulatory system so it can be naturally eliminated. Compression pumps increase circulation in the affected limbs while alleviating any painful symptoms.”

The compression pumps can also be used for patients with chronic wounds and non-healing ulcers, which can occur in people with venous insufficiency. The pumps assist in the wound healing process by circulating the healing factors in the blood.

“The pump’s sleeves are reusable and can be washed off with a damp cloth,” Alyssa describes. “If patients have open wounds, they can use the pumps, as long as the wounds are covered.”

Once Acute Wound Care received Martina’s prescription, a compression therapist contacted her to review the next step and answer any questions. After that, the therapist delivered the device, set it up and explained how to use and care for it.

“A therapist came to my home, set up the pump and talked to me for a while,” Martina confirms. “The therapist was excellent. She was very pleasant and knowledgeable, even about insurance and Medicare.”

The compression pumps from Acute Wound Care are prescription devices and are approved and covered by many commercial insurers.

Ongoing Benefits

Martina continues to elevate her legs whenever she sits, which she says helps reduce the swelling somewhat. But nothing helps more than her compression pump from Acute Wound Care. She counts on it for consistent relief of the swelling and pain from her venous insufficiency and lymphedema.

“I use the compression pump an hour at a time twice a day, morning and night,” Martina relates. “Afterward, my legs look and feel much better. Then they’re about a five, which is better than nine. When it gets hot or I walk a lot, my legs really swell up. Being able to come home and use the pump makes the pain better.

“Acute Wound Care’s compression pump is the only thing that’s ever really helped with my leg swelling and discomfort. I plan to continue using it.”

*Patient’s name withheld at her request.

For years, Larry Shanaberger has been getting treatment for his venous insufficiency, a condition in which his veins are unable to efficiently circulate blood from his extremities back to his heart.

Venous Disease & Lymphedema

Circulation problems such as this often result in dermatological problems and lymphedema, a condition in which excess lymph fluid collects in tissues of the legs and/or arms, causing swelling. The swelling can be severe, uncomfortable, making it hard for patients to bend their limbs and complete regular tasks.

In Shanaberger’s case, he was not only suffering from venous disease in his leg but had also developed lymphedema and a recurring ulcer on his ankle.

He says, “The wound would seep to the point that I was changing bandages several times a day.” Shanaberger works in a garden center and is on his feet for hours at a time. A seeping wound on his ankle was not only inconvenient but also challenging to heal.

His Vein Specialist exhausted conservative treatment options with him, so he was referred to Acute Wound Care for in-home compression therapy.

Compression Pumps

Compression pumps are not only used to treat venous insufficiency and ongoing open wounds but are also helpful for patients who have chronic edema, poor circulation, and lymphedema.

The devices have shown great success in boosting circulation and reducing swelling in both the upper and lower extremities. Alyssa Parker, Clinical Administrator at Acute Wound Care says, “Compression pumps have been around for decades. Although many doctors know about their use in hospitals to help with blood clots, many are still unaware that the treatment is available for in-home use as well.”

The pumps consist of long sleeves that fit from the foot to the groin or the hand to the shoulder. They contain multiple chambers that fill with air in a sequential motion, replicating the circulatory system and assisting blood flow from the extremities back to the heart.

Wound Care

The excess fluid in the limbs is worked back through the circulatory system where it can naturally be eliminated by the body. Removing excess fluid might make sense for the reduction of swelling, but how does wound care fit into the picture?

It is hard for wounds to heal when the body has poor circulation. Parker says, “It’s also important to use proper dressings. Individuals trying home remedies to heal a wound without proper dressings are at a higher risk of infection, which may lead to hospitalization.”

Shanaberger says, “They gave me these bandages that helped to absorb moisture from my wound while the pump was working. It was kind of a one-two approach to my healing. The bandages took care of the outside and the pump took care of the inside.” The process helped to dry out his wound in just a couple of weeks.

Parker adds, “I’ve seen cases where patients have been unsuccessfully treating a wound for as long as a year. With the right treatment and specialty dressings, our goal is to get the wound healed within 45 days.”

Quality of Life

Shanaberger uses the compression pump one to two times a day and says, “It makes my leg feel good. It’s kind of like a gentle blood pressure cuff where the pressure builds up then moves from the foot to the thigh, pushing all of that fluid up and out.”

He still uses a topical cream on the wound area and still bandages his foot before going to work to keep it dry but says, “The pump has made a world of difference in the size of my leg and my quality of life.”

The compression pumps are portable so patients can travel with them. A prescription is needed in order to obtain one. Parker says, “Many insurance carriers cover the treatment. The specialists at Acute Wound Care handle the entire process.”

“It was a very easy procedure from the time my doctor made the referral,” says Shanaberger. “Acute Wound Care did all of the insurance work, and they came to my home when it was convenient for me to help me use it.”

He adds, “I see a lot of people walking around with edema on their limbs and I wonder if they know about these pumps. I really want to go up to them and tell them about it. It makes such a difference.”

About Acute Wound Care

Acute Wound Care is family owned and operated by Tom & Alyssa Snyder. Tom is a native to Southwest Florida and Alyssa moved to the area in 1992. Together they have over 16 years of combined experience in Lymphedema, Venous Disease, and Wound Care.

The couple along with their expert staff make it a priority to understand each patient’s unique needs and give them the attention and care that everyone deserves. Their highly educated team has extensive product knowledge. The average heal rate for their patients is just 30-45 days!

Acute Wound Care is an Accredited Medicare provider and accepts most commercial insurance. Their staff guides you through your treatment options and covered benefits. In-home delivery with personalized instruction is also provided.

The Acute Wound Care team looks forward to assisting you and helping expedite the healing process!

A compression pump is widely recognized as effective treatment option for limb swelling. Compression pumps are a safe way to assist your body’s circulatory system in moving the excess fluid which has accumulated in the limb and can cause painful swelling, non-healing wounds, heaviness, and discomfort decreasing your mobility. The compression pump is a gentle massaging technique that compresses in a rythmatic cycle, similar to that of a normally functioning lymphatic system that has not been damaged. This is a great treatment option for patients who have tried compression stocking, elevation, diuretics, or massage with little or no relief. This is a non-invasive, safe and effective way to assist your body’s circulatory system in moving the excess fluid which has accumulated in the limb and can cause painful swelling, non-healing wounds, heaviness, and discomfort decreasing your mobility.

What does limb swelling have to do with your lymphatic system? The lymphatic system serves as one of the body’s main highways throughout its network of vessels and ducts, for body fluid entering into the blood stream. Before this body fluid also referred to as lymph fluid can enter the blood stream the lymphatic system works as a filtration system. Everything must pass through, from disease fighting immune components to cancer cells. Finding the cause of your edema is vital to getting the proper medical treatment. Many patients use diuretics (water pills) or compression stockings and receive little or no results with reducing the swelling. If compression stockings get worn out or stretched over time, many patients aren’t receiving the needed compression. Diuretics may be useless and harmful over time if your edema (swelling) is a symptom of chronic venous insufficiency or lymphedema. Diuretics draw fluid from your venous system that your body must have in order to balance the continual fluid deposit from your arterial capillaries; if the needed interstitial fluid is not present because you are taking a diuretic, this will only aggravate your lymphatic system which may lead to additional fluid retention and additional swelling.

By Alyssa Parker

Many individuals attempt to manage their limb swelling through various treatments such as compression stockings, exercise, diuretics, and elevation with little or no results. Limb swelling, also known as edema, may be a symptom of an underlying medical condition. Some of the most common conditions where limb swelling is the first symptom include venous insufficiency, post operative trauma, infection, and lymphedema. Clinicians may overlook the cause of your swelling; Lymphedema or venous insufficiency is not always evident in their earliest stages. It’s important to seek treatment early on to prevent further complications. These conditions can be easily misdiagnosed as acute and minor swelling followed with minimal treatment. Pneumatic compression devices are one of the most highly recommended treatments for these conditions and are recognized by Medicare.

Case studies on the management of dermal changes and wounds using biocompression pumps.

CLICK HERE to read case studies on the management of dermal changes and wounds using biocompression pumps.

As we age, in the normal course, our body's ability to heal itself will slow. This is natural. This is where we may need additional help from specialty dressings.

When the lymphatic system in your body becomes compromised it is unable to pump lymph fluid which contains lipids proteins and waste products from the tissue. When this happens a person will experience swelling in one or more extremities, which has resulted in the body’s inability to pump circulate the fluid properly.