Treatment Overview

At Indiana Vein Specialists, our team has received specialized training in the fitting and application of compression stockings, and are able to fit >95% patients that present with chronic lower extremity swelling. Identifying the etiology of chronic swelling is also key to managing this disease process.

With lower extremity lymphedema, compression strategies are considered the cornerstone of treatment. Our Physical Therapist, Sara Salinas, PT, CLT-LANA, is available for evaluation and treatment.

Treatment for Lymphedema May Include:

Manual Lymphatic Drainage, which is a light, gentle massage technique to help move fluids away from the congested area into an unaffected area to reduce the swelling.

Compression Bandaging, where a multi-layer of short stretch bandages work with the patients movement for further reduction of swelling.

Graduated Compression garments are worn during the day to help keep the swelling down, improve circulation, and prevent accumulation of lymph fluids in the involved area.

Pneumatic Compression Pumps, a mechanical device that works as a sleeve with inflatable chambers to help mobilize the fluid from the limbs.

Skin Care, including the application of a low PH lotion at least twice a day and avoiding nicks, cuts or abrasions, as the affected limb is more susceptible to infection.

Exercise which when used with compression, utilizes the body’s natural muscle pumping action to increase venous and lymphatic fluid return to the circulatory system and out of the affected/swollen area.

Bandaging Instructions:

Wear 23 hours a day.

Take off for 1 hour to clean and apply lotion.

After lotion dries, apply stockinette (should be longer than toes and knee).

Shape the leg in an upside cone with cotton, 0% pull.

Fold remaining stockinette over cotton.

Start with smallest bandage right below toes. Overlap 50% and pull </=50% with same amount of tension all the way up. We pump swelling out by the amount of layers (NOT the amount of pull). Make sure the most layers are at the toes and decrease amount of overlap as you wrap up the leg.

Things to remember:

Shape: Shape should be smooth and symmetrical, like an upside down cone. This will make the pressure equal around the entire leg. This reduces sores and helps proper draining. USE THE WHITE COTTON (OR BLACK FOAM) GIVEN TO ACCOMPLISH THIS STEP.

Tension: “Law of LaPlace”: If the radius of a cylinder increases, the TENSION also needs to increase to achieve the same pressure.

Since we want it softer at the top of your leg, you maintain the SAME amount of tension (how much you pull) throughout wrapping. A natural gradient will occur this way.

Layers: Never wrap around the same area twice. This will produce a tourniquet effect and make things worse. Always layer 50% over the previous bandage and always go up the leg, never down. If you have some bandage remaining once you get up to the knee, 0% pull.

MOVE MOVE MOVE while wearing your bandage, this will give better results!

Patient Instruction Videos:

The information contained within these videos and instructions is intended to assist and remind patients of correct bandaging techniques after treatment.

Please direct any questions concerning these instructions to Indiana Vein Specialists at or call us at (317) 284-9498.