Letter to editor re: Risks and contraindications of medical compression treatment – A critical reappraisal. An international consensus statement

Dear Editor,

I read with great interest the recent online article by Rabbe et al. regarding the adverse effects and contra-indications of compression therapy. This paper is made of two parts: a literature review and recommandations. ¹

Since compression therapy is widely used throughout the world, this paper is of great importance. The methodology used for literature research was clearly explained as well as the selection process that was chosen by this panel of experts. As a result, out of a plethora of papers, 62 have been selected for a detailed analysis. A first question is raised: in light of such adverse events, would it be more advisable to perform a more exhaustive research process and select more of the identified papers?

Moreover, recommendations that followed, which of course are for all prescribers of compression therapy worldwide, are based on the results of the review. I would attract the attention of the reader and insist that the recommendations are based on an incomplete collection of data. Allow me to explain. Included in the Medical Device Vigilance System is the Vigilance System on Compression Devices. Located in many countries worldwide, one of its missions is to improve the protection of health and safety of patients using compression devices. Based on reported cases through various means by users, healthcare professionals, hospitals, clinics and of course manufacturers, participants of the Vigilance system not only collect but carry out inquiries, the objective of which is to reduce the likelihood of adverse events related to the use of compression devices. ²

In France, as well as in other countries, vigilance compression device registries are accessible, and the results of inquiries are sometimes published when these cases are worthy of being reported to the medical community.^3,4 As a consequence, it would have been very valuable to expert members of this abovementioned panel to consult these registries in order to implement, if necessary, their recommendations to the community of compression therapy prescribers. At the least, it would have been preferable to mention in the methodology section why the vigilance reports were apparently not taken into account since their importance could not have escaped the attention of the compression experts and especially the manufacturer that promoted this work and acted as the secretary.