Today's Wound Clinic - Winter 2008 - (Page 38) intech Pneumatic Compression Pump Therapy: An Evidence-based Approach to the Treatment of Chronic Vascular Disorders Teresa Conner-Kerr, PT, PhD, CWS, CLT T he importance of compression therapy in treating tissue swelling associated with lymphedema and venous insufficiency is well recognized by wound management practitioners. Compression therapy is delivered by a variety of methods with differing levels of evidence to support the use of specific compression modalities. Treatment algorithms prepared by experts from a variety of disciplines using original research are available that provide evidence ratings for particular compression modalities.1,2 In The Venous Ulcer Guideline developed by the Government and Regulatory Task Force of the Association for the Advancement of Wound Care, an “A” level of evidence was assigned to eight different compression therapy options.2 One of the eight therapeutic modalities receiving an “A” level rating was intermittent pneumatic compression. Pneumatic compression pumps have been in use since the 1960s for the treatment of limb swelling due to both acute and chronic conditions. Pneumatic compression pumps consist of an electric pneumatic pump that is used to push compressed room air into an inflatable garment or sleeve either continuously or intermittently depending on inflation and deflation times. Most pneumatic compression pumps today use intermittent compression cycles with inflation and deflation cycles either preset or programmable by the clinician. The sleeve or garment may have a single chamber design with one port or a multiple chamber design with one port per chamber. Pressure may be graded with the highest pressures in distal Winter 2008 Today’s Wound Clinic chamber segments. Depending on the specific manufacturer, compression cycles, treatment times, and compression levels may be either preset or programmable. Multichamber sequential compression pumps typically provide the greatest programming flexibility. Newer compression pump technology such as the Lympha-pants™ (LymphaCare, New York, NY) employs large multisegment chambers that cover bilateral limbs and the lower or upper trunk simultaneously so that a comprehensive treatment may be delivered in a more efficient manner. The sequential inflation of chambers from distal to proximal in these devices is also thought to more naturally mimic lymph return. TABLE 1. Examples of pneumatic compression pump types and their associated HCPCS codes. Pump Brand Huntleigh-Flowplus® Huntleigh Healthcare L.L.C. (Eatontown, NJ) Pump Type I I I I II II II II II II III III III III III HCPCS Code E0650 E0650 E0650 E0650 E0651 E0651 E0651 E0651 E0651 E0651 E0652 E0652 E0652 E0652 E0652 Jobst-System 7000® Jobst (BSN-JOBST, Inc., Charlotte, NC) Talley-Multicom 100 Talley (Talley Group Ltd., Romsey, UK) Wright Linear® Pump-Solo50 Wright Linear Pump, Inc. (Oakdale, Pa) ® BioCompression-Sequential Circulator 2000-2004® Bio Compression Inc. (Moonachie, NJ) Jobst-System 7500(II)® Jobst (BSN-JOBST, Inc., Charlotte, NC) Huntleigh-Lymphatron® Huntleigh Healthcare L.L.C. (Eatontown, NJ) Kendall-Home Rx (5550)® Kendall (Tyco Healthcare Group, LP, Mansfield, Mass) Talley-Multicom 300 Talley (Talley Group Ltd., Romsey, UK) Wright Linear Pump-Solo 51 Wright Linear Pump, Inc. (Oakdale, Pa) ® ® Advantage-Advantage 2100® Advantage (Microtek Medical, Inc., Jacksonville, Fla) BioCompression-Sequential Circulator models 3000-3004® Bio Compression, Inc. (Moonachie, NJ) Chattanooga-PresSsion 4330 VGS® Chattanooga Group (Hixson, Tenn) Talley-Multicom 500® Talley (Talley Group Ltd., Romsey, UK) Wright Linear Pump-AutoPro 52 , and Pro 52 Wright Linear Pump, Inc. (Oakdale, Pa) *adapted from Blue Cross/Blue Shield of North Carolina Medical Policy3 ® ® 38
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