Compression modalities and dressings: their use in venous ulcers

Sackheim, Kimberly A.; Araujo, Tami S. De; Kirsner, Robert S.

doi:10.1111/j.1529-8019.2006.00092.x

Cited by 23 publications

(21 citation statements)

References 62 publications

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“…Compression therapy, used properly, is effective for treating VLUs; however, there are a variety of unmet needs with current treatment options. Inelastic bandages, for example, do not adapt to volume changes of the legs and require frequent reapplication; they provide high working pressure and low resting pressure, and pressure is maintained only over a short period of time (4,16). Elastic bandages are difficult to put on properly, and although they provide high pressure at the ankle that decreases towards the thigh, they can be dangerous for patients with arterial occlusive disease (3,4).…”

Section: Discussionmentioning

confidence: 99%

“…• compression therapy is the mainstay of treatment for venous leg ulcers (VLUs) and it is generally accepted that poor concordance with compression therapy ultimately affects ulcer healing and recurrence • six factors were reported to influence concordance: physical factors, patients' lack of education about their condition and the treatment prescribed, aesthetic and cosmetic factors, clinician issues, and less commonly, the cost of therapy • compression therapy is the mainstay of treatment for venous leg ulcers (VLUs) and it is generally accepted that poor concordance with compression therapy ultimately affects ulcer healing and recurrence the balance of which includes ulcers of arterial or mixed aetiology (2). Although a number of well established or emerging treatments are available, compression therapy, otherwise shown to be detrimental to people with arterial disease (3,4), is considered the mainstay of treatment and prevention of recurrence for leg ulcers of venous origin (5). Systems available for compression therapy include: compression bandages, largely used for VLU treatment (4,6); elastic hosiery which is considered the mainstay for prevention of VLU recurrence (4); and, more rarely reported, intermittent pneumatic compression (IPC) (4,6) which can be used on its own, but is usually combined with the use of compression bandages for VLU healing.…”

Section: Key Pointsmentioning

confidence: 99%

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Venous leg ulcers: patient concordance with compression therapy and its impact on healing and prevention of recurrence

Moffatt¹,

Kommala²,

Dourdin³

et al. 2009

International Wound Journal

122

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Moffatt Christine, Kommala Dheerendra, Dourdin Nathalie, Choe Yoonhee. Venous leg ulcers: patient concordance with compression therapy and its impact on healing and prevention of recurrence. ABSTRACT This study aimed to review available data on the reasons attributed to patient non concordance with compression therapy for the treatment of venous leg ulcers (VLUs), the frequency of non concordance and its effects on clinical outcomes. The biomedical literature was searched for publications on VLUs, compression therapy and concordance over the past 20 years. Physical, aesthetic and cosmetic factors, patient lack of education about VLUs, cost of therapy and issues with treatment by clinicians were all reported to influence concordance with compression therapy. The search identified 10 studies reporting patient concordance with compression stockings or bandages; while non concordance ranged from 2% to 42% of patients in three randomised controlled trials, it was generally higher in real-world studies, ranging from 9.7% to 80%. Another set of six studies indicated that the healing rate was half and the median time to complete healing was twice as long when patients were not concordant. Further, recurrence rates were 2-20 times greater when patients did not comply with the use of stockings following VLU healing. In conclusion, published biomedical literature has documented that non concordance with compression therapy negatively impacts the outcome of VLUs, highlighting the need to improve patient concordance to maximise therapeutic benefits.

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Section: Discussionmentioning

confidence: 99%

Section: Key Pointsmentioning

confidence: 99%

Venous leg ulcers: patient concordance with compression therapy and its impact on healing and prevention of recurrence

Moffatt¹,

Kommala²,

Dourdin³

et al. 2009

International Wound Journal

122

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“…Bu bandaj ile hastalann günlük aktiviteleri minimal düzeyde etkilenmekte, hospitalizasyon gerekmeden hastalann takibi kolayca yapilabilmekte, rijid özelligi sayesinde bacak-baldir pompasina destek saglanmakta ve travmalara kar §i ülser bölgesi korunabilmektedir (16). Guest ve arkadaflarmm yaptigi bir çali §mada DVY olmasinm ülser iyileçmesini etkilemedigi belirtilmif (25). Guest ve arkadaflarmm yaptigi bir çali §mada DVY olmasinm ülser iyileçmesini etkilemedigi belirtilmif (25).…”

Section: Gírí §unclassified

“…Unna bandaji, rijid kompresyon bandajlannin prototipi olarak kabul edilir (25). Hasta istirahat halindeyken daha dü §ük basmç, hareket halindeyken daha yüksek basmç oluçturmaktadir.…”

Section: Gírí §unclassified

Unna Boot in Venous Ulcer Treatment: Evaluation of 30 Patients

Acipayam¹

2013

J Turgut Ozal Med Cent

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Amaç: Bu prospektif çaliçma ile klinigimizdeki Unna bandaji uygulamalanmizda elde ettigimiz verileri degerlendirmeyi amaçladik. Gereç ve Yöntemler: Nisan 2007 -Agustos 2011 arasinda venöz ülser çikayeti ile baçvuran 1'i kadm, 29'u erkek toplam 30 hasta (23-56 yaçlari arasinda, ortalama 33,5) çalijmaya alindi. Tüm hastalara Unna bandaji uygulandi. Unna bandaji ile birlikte günde iki kez kalsiyum dobesilat 500 mg tablet verildi. Yara iyiie §mesini takiben tedaviye diz alti orta basinçli varis çorabi, kalsiyum dobesilat ile devam edildi. Bulgular: Ulserler 23 (%76) hastada medial malleol çevresinde, 2 (%0.06) hastada diz altinda yaygin, 2 (%0.06) hastada tibia orta bölgesinde, 2 (%0.06) hastada tibia 1/3 distal ve medial malleol çevresine yayilmiç ve 1 (%0.03) hastada lateral malleol proksimalindeydi. Hastalarin ülserli geçirdigi sure 1,5 ile 168 (ortalama 25,2) aydi. Olgulara 1 ile 6 kür (ortalama 2,13) Unna bandaji uygulandi. Yedi olguda (%24) Unna bandaji uygulanan bölgede ciltte kuruluk ve ka §inti ile seyreden dermatit görüldü. Ülser nüksü gözlenen 4 (%13) olgu Unna bandaji ile tedavi edildi. Hastalarin takibi sirasmda Unna bandajinin erken dönemde çikarilmasinm gerektigi hasta olmadi. Sonuç: Kronik venöz ülser tedavisinde Unna bandajinin, uygulanmasi ve temininin kolay, tedavi maliyetlerinin dücük, minimal komplikasyona sahip olmasi, arteriyel hastaligm da bulundugu olgularda diger kompresyon yöntemlerine göre daha güvenli olmasi ve diger yöntemlerden etkinlik açisindan bir farkinm bulunmamasi dolayisiyla akilda bulunmasi gereken bir yöntem oldugunu dücünmekteyiz. Abstract: Aim:We aim to evaluate the results of the Unna boot practice with this prospective study. Material and Methods: This study included a total of 30 patients (1 female, 29 male; ages 23-56, mean 33.5) admitted to outpatient clinic with chronic venous leg ulcers. All patients were treated with Unna's boot. This treatment combined with oral calcium dobesilat 500 mg tabletorally twice a day. As the ulcer was healing, the treatment continued with calcium dobesilate tablets and compression stockings. Results: Ulcer placement was as follows: around medial malleol 23 (76%); widespread below knee 2 (0.06%); mid-tibial region 2 (0 06%)tibia 1/3 distal region plus medial malleol 2 (0,06%), around lateral malleol 1 (0,03%) patient. Ulcer duration was between 1.5-168 nionths (mean 25,2). Unna boot was applied between 1-6 times (mean 2.13). Seven (24%) patients had dermatitis manifested with skin dryness and pruritis at Unna boot applied skin region. Four patients had ulcer recurrence and treated with Unna boot. Conclusion: We think that Unna bandage usage in chronic venous ulcus treatment must be taken into consideration because this treatment method is easy to supply and be applied, low cost of treatment, minimal complication rate and it can be performed effectively and more safely than other treatment modalities in patients with arterial disease.

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“…Nonetheless, PAOD is regarded as a limiting factor for compression therapy, as local under perfusion and hypoxia have been observed [24,33,34]. In response, the scientific literature offers a variety of treatment recommendations which mainly refer to the applied level of compression [2,13,25,30,36]. Recent studies in patients with moderate PAOD, defined as an Ankle Brachial Pressure Index (ABPI) between 0.5 and 0.8, confirmed that an average standing pressure of around 30 mmHg at the B1 location was safe and well tolerated [9,29].…”

Section: Introductionmentioning

confidence: 99%

Macro- and microperfusion during application of a new compression system, designed for patients with leg ulcer and concomitant peripheral arterial occlusive disease

Jünger

Haase

Schwenke

et al. 2013

Clinical Hemorheology and Microcirculation

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Objective: To investigate macro-and microperfusion during 14 days of treatment with a new 2-layer compression system (3M™ Coban™ 2 Lite), designed for patients with leg ulcer and concomitant peripheral arterial occlusive disease.Methods: A single-centre, open-label, prospective pilot study was performed with 15 subjects suffering from peripheral arterial occlusive disease with an ankle brachial pressure index (ABPI) of 0.5-0.8, who volunteered to have their 'study leg' bandaged with the new system. Coincident leg ulcer or chronic venous disease was not mandatory. All subjects received the new compression system, which stayed in place from 1 up to 4 days according to scheduled study visits. The system was reapplied by study personnel at each clinical visit (days 1, 2, 3, 4, 7, 10 and 14). The study participation stopped after 14 days. At each clinical visit safety assessments were performed: measurement of acral pulsation to capture macroperfusion; laser Doppler fluxmetry to capture microperfusion; clinical signs of pressure related skin damage, hypoxia-related pain and sub-bandage pressure measurement. In addition, the leg volume was measured and a comfort questionnaire was completed.Results: An average sub-bandage pressure in standing position of approximately 30 mmHg was measured at the B1 location immediately after bandage application. Laser Doppler fluxmetry demonstrated positive effects on microcirculation regarding vasomotion and respiratory reflux. No change of the cardiac signal appeared. For acrale pulsations a high intraindividual variability was found with no clear interference to the bandage application. No pressure-related skin damage or hypoxia-related pain was detected.Conclusion: After application of the new compression system in subjects with moderate PAOD, laser Doppler fluxmetry indicated significant improvements of the microcirculation. High variability and lack of correlation to clinical symptoms was found for the acral pulsation. The new compression system revealed a high grade of tolerability and a good safety profile.

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Compression modalities and dressings: their use in venous ulcers

Cited by 23 publications

References 62 publications

Venous leg ulcers: patient concordance with compression therapy and its impact on healing and prevention of recurrence

Venous leg ulcers: patient concordance with compression therapy and its impact on healing and prevention of recurrence

Unna Boot in Venous Ulcer Treatment: Evaluation of 30 Patients

Macro- and microperfusion during application of a new compression system, designed for patients with leg ulcer and concomitant peripheral arterial occlusive disease

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