CLT Compression Therapy & Bandaging 1 — Questions and Answers
Question 1: In Complete Decongestive Therapy (CDT), multi-layer compression bandaging applied during the intensive phase uses what type of bandage as the primary working layer?
- High-stretch elastic bandages
- Short-stretch (low-stretch) bandages (Correct answer)
- Foam padding only
- Cohesive self-adhesive elastic wraps
Correct answer: Short-stretch (low-stretch) bandages
Short-stretch bandages have low elasticity and create high working pressure during muscle contraction and low resting pressure when the muscle is relaxed, ideal for lymphedema.
Question 2: What is the primary difference between 'working pressure' and 'resting pressure' in compression therapy?
- Working pressure is applied by the therapist; resting pressure is applied by the patient
- Working pressure is generated when muscles contract against the bandage; resting pressure exists when the limb is still (Correct answer)
- Working pressure refers to compression garment class; resting pressure to bandage layers
- They describe the same concept with different names
Correct answer: Working pressure is generated when muscles contract against the bandage; resting pressure exists when the limb is still
Working pressure is the high pressure created when muscles expand against the inelastic bandage during exercise; resting pressure is the low constant pressure when the limb is at rest.
Question 3: Compression garments for lymphedema are classified by compression class. What pressure range defines Class I (mild) compression in the US (Juzo/Sigvaris flat-knit classification)?
- 8–15 mmHg
- 15–20 mmHg
- 20–30 mmHg (Correct answer)
- 30–40 mmHg
Correct answer: 20–30 mmHg
Class I compression in US lymphedema garment classification corresponds to 20–30 mmHg and is often prescribed for mild or well-controlled lymphedema maintenance.
Question 4: Foam padding layers applied beneath short-stretch bandages serve what purpose?
- They replace the need for MLD
- They protect bony prominences and evening out the pressure distribution over irregular contours (Correct answer)
- They increase total compression pressure
- They are used only for cosmetic reasons
Correct answer: They protect bony prominences and evening out the pressure distribution over irregular contours
Foam and chip-bag padding protect bony prominences, fill concavities, and redistribute pressure evenly to prevent localized pressure injuries under bandages.
Question 5: Which of the following is a contraindication to compression bandaging in a lymphedema patient?
- Mild pitting edema
- Acute cellulitis with systemic infection signs (Correct answer)
- Post-surgical swelling after 6 weeks
- Moderate fibrotic tissue changes
Correct answer: Acute cellulitis with systemic infection signs
Active cellulitis with systemic signs (fever, spreading erythema) is a contraindication because compression over infected tissue can spread infection and cause pain.
Question 6: What is the recommended ankle-brachial index (ABI) minimum threshold before applying compression wrapping to a patient's lower extremity?
- ABI > 0.5
- ABI > 0.8 (Correct answer)
- ABI > 1.0
- ABI does not need to be checked for lymphedema
Correct answer: ABI > 0.8
An ABI greater than 0.8 is generally required before applying compression to the lower extremity to avoid compromising arterial blood flow in patients with peripheral arterial disease.
CLT Compression Therapy & Bandaging 1
In Complete Decongestive Therapy (CDT), multi-layer compression bandaging applied during the intensive phase uses what type of bandage as the primary working layer?