443 compression and intermittent pneumatic compression (IPC) treatments were delivered over three months at a hospital orthopedic department. 3 adverse effects were reported, correlating to an incidence rate of 0.7%. Most adverse effects were low grade. Compression bandages and stockings had a 0.8% adverse effect rate while IPC had 0%. The department uses compression extensively and focuses on proper application, which may account for the low adverse effect rate. Future registration efforts will separate bandages and stockings to better analyze adverse effects.

1. E W M A 2 0 1 3 D E N M A R K
Nordsjællands Hospital-Hillerød Department of Orthopedics 2013
COMPLICATIONS
ASSOCIATED WITH
COMPRESSION AND
INTERMITTENT
COMPRESSION
THERAPY (IPC)!
Md. Jonas Hedegaard Andersen!
Md. Mikkel Sundstrup!
Wound Care Nurse Nina Baekmark!
Poster : EP447
Orthopedic
Department!
Hillerød!
Compression
Therapy
Intermittent Pneumatic
Compression (IPC)

2. E W M A 2 0 1 3 D E N M A R K
NordsjællandsHospital-HillerødDepartmentofOrthopedics2014!
Theory!
Compression and IPC has become an
integral part of medical therapy in
more than one aspect.!
Both IPC and compressions role in
prevention of Thrombosis have been
proven1-2.!
Compression and IPC have become
an important part of ulcer
manegment3-5 In addition to this
there has been some evidence that
IPC has a role in fracture
manegment6!
From the prevailing evidence and our
own experiences with compression
and IPC, the two modalities have
become every day tools in our
orthopedic department. !
Compression and IPC is used every
day in the management of wounds,
fractures, compartment syndrome,
etc.!
To our knowledge there hasn't, to
this date, been any documentation of
the incidence of compression
damages.!
The aim of this poster was to register
the number of IPC and compression
treatments delivered, and the number
of adverse effects in a three month
period at our department!
Method!
Prior to the registration period,
personnel in our Department,
including operation ward, out
patient clinic and bed wards, were
informed verbally and by E-mail,
about the project.!
Handouts with coding for
treatment with compression and
IPC, along with an e-mail address
for the registration of adverse
effects, were handed out at the
departments. !
After the three month period the
codes were drawn from our
registration system and analyzed,
along with all the reported adverse
effects!

3. E W M A 2 0 1 3 D E N M A R K
NordsjællandsHospital-HillerødDepartmentofOrthopedics2014!
Results!
In the three month period a
total of 443 compression
and IPC treatments were
delivered. In the same
period 3 adverse effects
were registered. This
correlates to a incidence of
adverse effects of 0.7%!
If the treatments are broken
down into one group
compromising compression
stockings and bandages
and one group with IPC the
incidence of adverse effects
is 0.8 % and 0 %
respectively for bandages/
stockings and IPC. (se tab.1)!
Of the adverse effects 2 can
be classified as grade 1, and
1 as grade 2 according to
the NPUAP-
classification7(se tab.2)!
Treatment No.
Treatments
No. Adverse
Events
Incidens in %
Compression
Bandages/
Stocking
386 3 0.8 %
IPC 57 0 0 %
Total 443 3 0.7 %
Tabel. 1
Grade 1 Grade 2 Grade 3 Grade 4
No. of events 2 1
Tabel. 2 Grades as described by NPUAP-classification7

4. E W M A 2 0 1 3 D E N M A R K
NordsjællandsHospital-HillerødDepartmentofOrthopedics2014!
Discussion!
This poster documents that there are
relatively few adverse effects linked to
compression and IPC treatment (<1 %).!
And that most of the adverse effects are of a
low grade. These results are from a
department were compression is an integral
part of our treatments of a wide verity of
ailments. We probably use compression
more than most departments, and at the
same time there has been a focus on
teaching application of compression, and
the theory of compression. Therefore our
department is probably not a average
department when it comes to the use of
compression therapy. !
In our opinion every department that utilizes
compression, should have focus on
teaching application and therapy
compression. By teaching these two points,
every department can, in our opinion, reach
similar results. !
It should be noted that two of the three
adverse effects reported was in relation to
treatment with compression bandages of
edema in relation to externally fixated
fractures of the lower limb. This is not a
normal treatment modality, but has been
developed and implemented at our
department over recent years.!
Future Perspective!
The registration was most
likely not complete in this
observation period. This will
be rectified in later
observation periods, by better
information both
electronically, in paper form
and verbally!
In the next observation period
compression bandages and
stockings will receive separate
codes!

5. E W M A 2 0 1 3 D E N M A R K
NordsjællandsHospital-HillerødDepartmentofOrthopedics2014!
1: ”Stratified meta-analysis of intermittent pneumatic compression of the lower limbs to prevent venous thromboembolism in hospitalized
patients.” Ho KM1, Tan JA. Circulation. 2013 Aug
2: ”Elastic compression stockings for prevention of deep vein thrombosis” Sachdeva A1, Dalton M, Amaragiri SV, Lees T. Cochrane
Database Syst Rev. 2010 Jul
3: ”Compression for venous leg ulcers” O'Meara S1, Cullum N, Nelson EA, Dumville JC. Cochrane Database Syst Rev. 2012 Nov
4: ”Compression for preventing recurrence of venous ulcers.” Nelson EA1, Bell-Syer SE. Cochrane Database Syst Rev. 2012 Aug
5:”Intermittent pneumatic compression for treating venous leg ulcers.” Nelson EA1, Mani R, Thomas K, Vowden K. Cochrane Database Syst Rev. 20
11 Feb
6: ”Intermittent pneumatic compression in fracture and soft-tissue injuries healing” Khanna A1, Gougoulias N, Maffulli N. Br Med Bull. 2008
7: http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?productid=1492&pageaction=displayproduct