Compression in indian villages ilf p pt

Dr. S.R. Narahari, MD, DVD (Modern Medicine)

Director

E-mail: srnarahari@sify.com www.iad.org.in

Over 7 million morbid cases LF distribution in India

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Courtesy : NVBDCP, New Delhi

Ayurveda Biomedicine Yoga

CounselingCompression

Therapy

Integrative Treatment

Patient Education

Home based and Self-care Treatment

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Cotton and rubber

thread:

-300% extensibility

-100% elastability

Priced at 4.5 per unit

Durability: 2 weeks

30 companies

manufacture but only

one meets quality

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We get them when

donated from Europe

Mr. Gerban , Schrale, Physiotherapist

Ms. Malou van Zanten, a skin care therapist

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Choky bagSandwich mould

T mould

CCF mould

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MCR

sheet is cut

and made

into

moulds

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Prevents constriction and facilitate free flow of lymph

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CCF Mould

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Cholky bag

Sandwich mould

Step 1: Toe compressionStep 3: Cloth wrapping

Step 4: Placing CCF sheet

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Step 2: Placing sponge mould

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Cotton cloth

wrapping

Protuberances

sagging from thigh

region

Long stretch

bandaging in figure

of 8 method Bandaging up

to thigh

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Sagging oedema

below knee region

Prone position with leg

bent backward

Compression of the

sagging region

Foot compression in

Supine position

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Cotton cloth

wrapping

Toe and foot compression in

sitting position

Compression given with other

limb flexed

Forefoot compression

Double layer compression

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Half compression

Full compression

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Mid thigh compressionHalf- half compression

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Challenges of compression therapy

in resource poor Indian village

Work ambiance

Size and shape

No support from family

illiteracy

Availability of product

Bony deformities of

limb

Upper and lower limb

involvement

Previously operated

limb

cost

Co-morbities and

complications

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By using Maximal Bulk of the limb ,one

of the 8 girth measurements, we estimate

the no. of bandages.

The regression model for estimating no.

of compression bandages needed is

E.g.., if maximal bulk is 45 cm, no. of

bandages needed for that patient are 4.

Using Math lab software

• Co-morbidity and complications

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• Co-morbidity and complications

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• Co-morbidity and complications

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Excoriation

Constriction

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Friction induced blisters due to MCR mould placed directly

over the skin

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Bullous formation due to friction of long stretch

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Excoriation caused by sponge moulds used to separate crevasse

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Rolling back of long stretch bandages in upper part cause

constriction effect

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Slipping of compression bandages in to large crevasses cause constriction

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Footwear used pushes the bandages backwards causing constriction

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Evaluation

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Alleppey

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Alleppey

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Gulbarga

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Gulbarga

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IAD

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IAD

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Occupation Daytime Night

Fisherman Not doing 5 hrs

Coir worker Not doing 6 hrs

Manual laborers Not doing 8 hrs

Driver 10 hrs 6 hrs

Pensioner 8 hrs 1 hr

Unemployed 5 hrs 10 hrs

Govt. employees 8 hrs 8 hrs

Housewife 10 hrs 6 hrs

Farmer/ Coolies in dry

land

8 hrs 5 hrs

Business people 10hrs 10hrs

Barbers 10 hrs 6 hrs

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Foot end elevation while resting at work

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