The extent of these effects depends upon compression pressure, the used compression and the mobility during compression.

Compression Bandaging Treatment:

The bandage material used determines the depth of the compression effect on the epidermis or deep regions. Short stretch bandages are primarily used for the compression of cellulite, primary and secondary lymph edema and combination forms (i.e. venous-lymph edema, venous-lipo-lymphedema).

The use of short stretch bandages cause high pressure during exercise and general physical activity and relatively low pressure while the body is resting. An ACE^® or long stretch bandage is not as useful for compression because the required bandage pressure results in a disturbed skin perfusion. Short stretch bandages, however, allow adequate drainage of the lymphatic fluid, waste ands toxins. The massaging effect of the bandages on the tissues underneath can be enhanced by special padding foam of high density. Even obstinate connective tissue proliferation can be loosened this way.

Compression Stocking/Garment Treatment:

There are four standardized grades of compression stockings/garments available to treat cellulite, edema and the various combination forms. For cellulite and post surgery edemas three grades of compression are recommended:

• Grade 1: Superficial effect; ankle pressure 18-21mmHg
• Grade 2: Medium superficial effect; 25-32 mmHg
• Grade 3: Superficial & deep tissue effect: 36-46mmHg

Compression stockings/garments are customized following four to six weeks of compression drainage therapy-manual lymph drainage, bandaging, exercise and compression pump. Sufficient long-term therapy vitally depends on the proper adjustment and use of compression stockings/garments. There is no standard formula for the correct adjustment. However, individual differences such as severity and localization of edema, the client’s age and the existence of an additional problem must always be considered. Exact individual adjustment of the compression garment is an important precondition to achieve optimal wearing comfort. The desired effect can only be achieved with full compliance of the client.

Compression Pump Treatment:

Intermittent pneumatic compression with multiple chamber instruments and pressure built up from distal to proximal has been used in Europe to support and conserve the therapeutic effect of the Combined Compression Therapies.

Instrumental compression, 20-80mmHg, has been beneficial to manage peripheral edemas (and cellulite) of the arms and legs, respectively, because of technical reasons. However, pneumomassage of the legs and arms causes the edema to shift into the adjacent trunk quadrant, which must then be treated with manual lymph drainage.

Only recently multi-purpose full body pneumomassage devices have been introduced by the manufacturers of the therapeutic compression extremity pumps widely known for its effectiveness in the treatment of lymphatic and venous disorders.

These compression devices should be peristaltic and should not exceed 80 mmHg compression values, which is the recommended norm for such kind of device. This full body suit, covering the trunk quadrants, performs a peristaltic massage in two stages. The body suit ensures effective and total treatment from ankles to shoulders. The pressure adjustable jacket 20 to 80 mmHg gives an upper body massage of the arms and shoulders and the pants provide a lower body massage of the legs, thighs, abdomen, hips and buttock, thus accounting for trunk drainage. Comprehensive research by plastic surgeons and physiotherapists has been showing promising results in removal of excess interstitial stagnating fluid accelerating venous and lymph fluid return.

These unique devices have also been very effective in fluid activation in pre-and post liposuction procedure, varicose veins and cellulite (lipedema) problems. It is important to continuously evaluate the client’s progress in edema reduction. Since instrumental compression is limited to peripheral edema, it is often necessary to supplement this treatment format with manual lymph drainage massage and/or bandaging in order to accomplish optimal results.