Diabetics Socks and Compression Wear

What is a sequential compression device?

A sequential compression device, or lymphedema pumps pneumatic compression device, is a full air pressure massager system that delivers intermittent compression on the external vascular and arterial system of the legs.

Sequential Compression Devices are designed to improve venous return and limit the development of Deep Vein Thrombosis (DVT) and Peripheral Edema (blood pooling) in the lower calf area of patients who are immobile for long periods of time due to recuperation from an injury or post-op surgery.

A Sequential Compression Device consists of an air pump connected to a garment that may be a sleeve, wrap or boot, by an air tube or series of tubes.

A similar form of therapy which combats the same conditions is the Foot Pump which artificially stimulates the venous plantar plexus (large vein located in the foot) to increase blood circulation in bed-ridden patients by simulating the motion of blood produced during walking.

Sequential compression devices are used by many treatment facilities such as hospitals as well as at home by lymphedema patients who need routine treatment.

Types of lymphedema pumps

There are currently two types of lyphedema therapy pumps (A Sequential Pneumatic Gradient Pump and A FlexiTouch Pump) with the major difference in these types of pumps being the manner in which the preparatory phase is managed.

A Sequential Pneumatic Gradient Pump

A Sequential Gradient Pneumatic Pump pushes air into chambers built into a garment, e.g., a sleeve, wrap or boot, which is worn over the leg or in the case of a boot on lower portion of the leg to cover the calf muscle.

The garment inflates and deflates in gentle sequential movements that massages the surface of the legs which imitates the natural flow of lymph from the distal end of the limb (foot) toward the trunk of the body.

With this pump device, the “preparatory phase” is performed manually either by the patient or lymphedema therapist before the sleeve or wrap is worn.

Before using the pump for the first time, consult with your lymphedema therapist as to the position of the limb being treated, the pressure settings on the pump, and the suggested frequency and length of each treatment.

Note: If using this device at home consult with your lymphedema therapist as to the position of the leg(s) being treated, the pressure settings on the pump, and the suggested frequency and length of each treatment.

A FlexiTouch Pump

A FlexiTouch Pump is used in a similar fashion as the Sequential Pneumatic Gradient Pump. The garment is placed on the leg of the patient who assumes the recommended position before the system is turned on. After the system has completed the preparatory phase it will automatically moves into the drainage phase. It is important that both phases by completed at one time. This takes about an hour each day.

The FlexiTouch Pump differs from other pumps in that it automatically completes both treatment phases. When you receive your pump the settings should be adjusted for both the preparatory phase and the treatment phase including the proper pressure and length of treatment.

Note: A hospital grade sequential leg compression sleeve can contain up to ten inner chambers or air pockets, whereas most home units, both stand alone and portable, will typically contain four to eight, depending on the brand or model. A portable sequential leg compression device functions using the same principle as a hospital grade pumping unit but delivers considerably less pressure.

How does a sequential compression device work?

A sequential compression sleeve is fed pulsated air through a tube or series of tubes from a pump that is connected to a compression sleeve with inner pockets that inflate and deflate the sleeve’s chambers in sequence which delivers an intermittent gradient massaging effect to the leg’s vascular system and muscle groups.

The chambers of the garment are sequentially inflated from ankle to knee (or mid thigh) to a maximum pressure of 45-50 mmHg at the ankle, 35 mmHg at the calf, and 30 mmHg at the thigh (hence the term “gradient” compression). The duration of compression is typically 11 seconds with a 60 second relaxation period between compressions depending on the brand and configuration.

This duration occurs after each heartbeat, every other heartbeat or every third heartbeat, and is then at rest during moments of heart contraction and arterial inflow into the lower extemities.

This lymphedema compression allows the heart to empty its blood easier thus freeing it from having to work to return blood to the heart and decreasing the work of the heart contraction.

How important are compression boots?

Pneumatic sequential compression boots are a simpler means of treating extreme or abnormal swelling due to a venous disorder such as lymphedema that often occurs in the legs and feet. By that I mean that they are much easier and less expensive and can be used at home as opposed to making trips to a health facility.

A pneumatic compression boots are inflatable garments and as the name implies they are in the configuration of a boot comprised that is hooked up to an electrical pumping device which inflates and deflates the boot according to a set number of times and pressures.

Note: It’s always to first confer with your physician or health care specialist to determine what settings will best treat your particular condition. Applying too much pressure could cause serious damage.

Common uses for leg Lymphedema Sequential Compression Devices

• Promotes good circulation.
• Relaxes tense muscles.
• Stimulates muscles to keep you moving after long periods of inactivity.
• Eases stiffness.
• Relieves fatigue and muscle leg pains.
• Treating infected ulcerated legs
• Reduce swelling caused by lymphedema
• Preventing chronic venous insufficiency (CVI)
• Preventing deep vein thrombosis (DVT)
• Preventing venous ulcers
• Helping ambulatory, as well as non-ambulatory people, soothe sore muscles.
• Compression therapy for treatment lymphatic and venous disorders

Common terms for sequential leg compression devices

Common terms for pneumatic lymphedema pump:

• Lympha Press
• diabetic pump
• pneumatic sequential-compression boots
• Sequential Gradient Pump
• Lymphedema Pump
• SCD boots
• Intermittent Pneumatic Compression System
• Air compression leg wrap
• Hospital compression boot
• Air pressure pumping device
• Arterial pump for edema
• Electric compression stockings
• Pneumatic leg compression massager
• Medical device to reduce swollen legs
• Sequential compression system
• Post surgical circulation boot
• Compression Therapy Boots

Purchasing a pneumatic compression pump

Since the pump is used at home it is necessary that the patient purchase this piece of equipment. Before making this investment, it is recommended that you investigate the pump carefully to be certain that it will work for you. You must also determine that you will follow through the daily routine of using it.

The patient must be motivated to use the pump regularly and in accordance with the instructions for its use. As with other lymphedema treatment plans, without patient compliance the treatment cannot be successful in controlling the swelling of lymphedema.

Tips for selecting a sequential leg compression device

1. Rely on your doctor’s recommendations on what type of leg compression device you should purchase which may include one of several popular brands (see below). Such devices can be somewhat complicated to operate if you’re new to using them and may require assistance.
   It’s tempting to purchase an off-name brand to save a few dollars but if your doctor or health care physician who is familiar with your specific health situation makes a recommendation for a tested product for your situation, it’s advisable to follow his/her advice .
2. Don’t purchase a used or refurbished model – you don’t know what you’re getting! Going with a used model could put your health at risk if it doesn’t work properly. The investment you make in a compression pump machine will be one of the most important investments you make because it will help you live a longer and healthier life, allowing you to succeed at work and home and spend more time with family and friends. Unauthorized dealers may purchase your sequential compression device from a middleman. They may not work properly and you will never know. In addition, you may pay a significant amount of money and not have warranty coverage. The risk isn’t worth it.
3. Avoid websites that offer cheaper brands of lymphedema products. Instead look for a website that offers machines with warranties from the quality manufacturers and offers free customer care and support. When you’re buying equipment that costs you or your insurance company hundreds to thousands of dollars you deserve access to customer support if you need it.
4. Look for brands recommended by recognizable organizations, such as the American Diabetes Association (ADA). If you’re unsure about a specific brand contact the manufacturer directly or one of their distributors for information about their product offerings, warranties, and customer service so you can compare.

Sequential Compression Devices are sold to the consumer under a variety of terms, e.g., SCD*-boots, Portable Sequential Compression Device, Compression-Boot for Edema, Sequential Compression-Boot, Leg Compression Device, Lymphedema Pump, and Post-Surgical Anti-clot Leg Device.

Popular sequential leg compression device brands

• Jobst 7500
• Kendall 5325, 6325
• Kendall AV Impulse 5000
• Kendall AV Impulse 6060
• NuTech Plexipulse
• Huntleigh
• DVTCare
• Presssion 3-Chamber Sequential Compression Pump
• Presssion 6-Chamber Sequential Compression Pump
• PlexiPulse Foot Compression Therapy (Doctor’s prescription required)
• System 7500 Sequential Extremity Pump
• LYMPHA PRESS®
• LYMPHA PRESS MINI®

Popular stand alone and portable Sequential Compression boots and leg messager devices

Auto-Edema-Reduction-boot
This device typically includes a cold pack option to provide cold therapy as well as compression to the leg to treat injuries related to sports or rigorous activities. Some designs may include a grip sole to enable the user to walk while wearing the boot. This type of device can treat the entire lower leg and foot. Combined with the PresSsion sequential compression pump, it achieves the best of active and passive compression therapies.

The C-boot is not battery powered nor does it have external pumps, i.e. it is completely portable and depends on movement from your own body to generate power. It has three chambers that inflate using a mini-compressor that starts at the ankle and works upward and includes a section for the foot, which does not inflate.

The C-Boot, often referred to as a pneumatic sequential-compression boot, is recommended for the treatment of vascular conditions such as leg ulcers, chronic venous insufficiency (CVI) and stasis dermatitis, lymphedema, and for the prevention of Deep Vein Thrombosis (DVT).
 
Verseo Cordless Air Pressure Leg Massager - The Verseo Cordless Battery Powered Leg Massager is a nice little compact leg wrap that is designed to improve circulation and counteract conditions that contribute to deep vein thrombosis (DVT) and embolism, serious blood clot condition and is approved by the FDA to improve blood circulation for those who must sit for extended periods of time.

Because there are no bulky tubes and external pump the Verseo Leg Massager can be worn anywhere; just wrap it around your arm or leg, turn it on and let the gentle automatic inflation and deflation cycles massage away tension, stress and pain.

It works by simulating the expansion and contraction of the calf muscles. The Verseo Cordless Leg Massager provides the same type of pressure as hospital compression boots, at a fraction of the time, cost, and inconvenience.

The massager delivers 70-130 mmHg of pressure, compared to the 15-20 mmHg delivered by compression stockings. It features 15-minute program and automatic modes, artificial-intelligence air pressure sensor, and three intensity settings. Fits calves and biceps up to 20″ in diameter. Requires two AA batteries (not included) that provide up to five hours of use. 4 1/2″ L x 2 1/2″ W x 2 1/2″ D.

Revitaleg Portable Pneumatic Compression Leg-Massager – RevitaLeg is an intermittent pneumatic compression massage device that helps improve circulation and reduces swelling caused by edema in the legs and feet for people who are inactive for long periods of time.

The RevitaLeg wraps around the leg and similar to an electric Sequential compression device pump it delivers a massaging action by the inflating and deflating of its cuff. The squeezing of the muscles acts as a pump to help improve circulation in the lower leg and foot.

Huntleigh Gradient Segmental Compression System Garment – This type of device is intended to treat lymphedema and venous insufficiency by delivering gradient segmental compression to the legs (also the arms).

It is available in a variety of sizes and is designed to prevent pinching and chafing.

The Huntleigh Gradient Segmental Compression System Garment comes with full-length zippers for easy application and removing (Console garments are sold as 1 garment per package, not sold in pairs.)

A bilateral connector is not needed to use two garments. The Huntleigh Gradient Segmental Compression System Garment is capable of providing arm and leg compression.

The measurement guidelines are simple one however the measurement will need to be done with some assistance.

The guidelines are as follows – Arm Length: Measure underarm to fingertips. Leg Length: Measure inseam thigh to heel.

Special Features:

• Increases venous and lymphatic flow
• Augments extracellular fluid drinage
• Reduces swelling and enhances wound healing
• Considerable reduction in ulcer size when used as an adjunct to the treatment of leg ulcers
• Features maximum comfort (soft and pliable)
• Washable
• Lightweight, portable pump features pressure gauge, pressure regulator dial, low pressure alert light, illuminated on/off switch, and hanging strap
• Ideal for home use

Specifications:

Power: 110-130v, 60Hz, 14W
Size: 10.5 x 3.5 x 4.5 inches
Weight: 3.75 pounds
Pressure Range: 30-70 mmHg
Cycle Time: Inflation 50 seconds, Deflation 70 seconds

DVTCare™

The “DVTCare” is portable (the pump weighs less than 1 lb.), has a battery that lasts up to 17 hrs on one leg or 8 hrs. on both (can be fully recharged in approx. 2.5 hrs.), and it can still be worn while it’s being recharged.

Insurance coverage for lymphedema pumps

A pump is a major expense; however most insurance plans, including Medicare, will approve the purchase of a pump as Durable Medical Equipment (DME). The first step for this process is to obtain a written prescription from your physician for this equipment.

Because of price differences some distributors or retailers only approve a less expensive model that may not meet your needs; however most manufacturers will assist you by providing sufficient documentation of the need for the more expensive model. With this documentation some insurance companies will approve this purchase. Others will only pay their share of the cost of a less expensive pump and allow the patient to pay all of the difference.

Although the insurance company agrees to the purchase the pump is not free because the patient is responsible for the co-pay portion which is usually 20% of the cost of the pump. In short, choose one wisely.