Effectiveness of the different components of complex decongestive therapy in patients with chronic venous insufficiency: A systematic review.

ObjectiveThe main objective of this study was to investigate the efficacy of complex decongestive therapy in patients with chronic venous insufficiency. Secondly, the suitability of manual lymphatic drainage, bandaging, and sequential pneumatic compression therapy - as key compression modalities of complex decongestive therapy - was examined.Data sourcesA search strategy was conducted in the Medline and Web of Knowledge electronic databases. The terms "chronic venous insufficiency", "chronic venous disease", "varicose veins", "kinesio taping", "pneumatic compression", "multilayer bandage", "manual lymphatic drainage", and "complex decongestive therapy" were combined with of the Boolean Operators "OR" and "AND".Study selectionTen articles exploring the efficacy of complex decongestive therapy in patients with chronic venous insufficiency were retrieved. The efficacy of the treatment and also the effectiveness of each of the maneuvers that make up the complex decongestive therapy studied separately as investigated.Data extractionTwo researchers extracted the data from each study independently and cross-checked the results to eliminate any errors. The characteristics of each study were collected, including participants, demographic characteristics, intervention measures and performance, and study design.Data synthesismanual lymphatic drainage treatment decreased the venous reflux, edema, clinical severity, symptoms, and quality of life. Kinesio taping improved peripheral venous flow, ankle function, edema, pain, quality of life, venous symptoms, venous severity disease, and mental health. Sequential pneumatic compression increased venous blood flow and quality of life, while complex decongestive therapy reduced limb volume and pain intensity and improved activities of daily living.ConclusionsThe combined use of these techniques is proposed in the symptomatic treatment of VI, just as they are used in the treatment of lymphedema. However, further studies are needed to effectively assess CDT and define its treatment parameters.