Low‐grade elastic compression regimen for venous leg ulcers – an effective compromise for patients requiring daily dressing changes

Abstract

Venous leg ulcers affect millions of patients worldwide and are a tremendous financial burden on our healthcare system. The hallmark of venous disease of the lower extremities is venous hypertension, and compression is the current mainstay of treatment. However, many patients are noncompliant, in part because of the complexity of the dressings and the difficulties with application and removal. The aim of our study was to determine an effective compression dressing regimen for patients with venous leg ulcers who require changing the ulcer primary dressing twice daily. We used two layers of a latex free tubular elastic bandage for compression. The primary endpoint of our study was increased wound healing rate and our secondary endpoint was complete wound closure. All active study subjects had positive healing rates at week 4 and week 8. Two subjects achieved complete wound closure by week 8. We conclude that compression with a latex-free tubular elastic bandage can be safely used in patients with venous leg ulcers requiring frequent dressing changes. This type of compression allows for daily inspection of wounds, dressing changes at home, flexibility in the context of clinical trials, and is a compromise for patients that are intolerant to compression dressings.

Mesenchymal Stem Cells in Chronic Wounds: The Spectrum from Basic to Advanced Therapy

“…Our recent pilot trial showed that tubular elastic bandages are a good compromise in stasis ulcers requiring frequent dressing changes. 25 Pressure-relieving devices and surfaces. Pressurerelieving devices and surfaces (including beds, mattresses, and cushions) are meant to redistribute pressure and are used as treatments for pressure ulcers.…”

Terapia compressiva: bota de Unna aplicada a lesões venosas: uma revisão integrativa da literatura

“…The final sample had 22 articles, as shown in Chart 2, encompassing 15,931 individuals aged 35 years or over. Eleven studies (50%) included participants from South America (18)(19)(25)(26)(27)(28)(29)(30)(31)(32)(33) , four (18%) from North America (34)(35)(36)(37) , four (18%) from Europe (38)(39)(40)(41) , one (4%) from Australasia (42) , one from Asia (43) and another (4%) from Oceania (44) . The longest follow-up time was 13 years (35) , and the lowest time was 28 days (33) .…”

“…In all articles there was always an author from nursing departments or institutions. There were several study designs divided as follows; one of each (5%): longitudinal (18) , comparative analysis (36) , qualitative analysis (32) , case-control (27) , descriptive (33) and observational (35) ; two of each (9%): cross-sectional (26,44) and retrospective (28,33) ; three of each (14%): cohort (28,34,40) and case reports (19,29,31) ; and eight (36%) clinical trials (25,30,(37)(38)(39)(41)(42)(43) , among which four (18%) were controlled trials comparing two or more types of compression therapies, and taking into consideration the rate of reduction or healing of the injury as an evaluation parameter, as described in Table 1.…”

“…In this review, seven types of compression therapies were mentioned, namely: the Unna boot (14 studies; 63%) (18,(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)44) ; single-layer bandage (five studies; 23%) (26)(27)40,42,44) ; two-layer bandage (two studies; 9%) (37,44) ; three-layer bandage (two studies; 9%) (43)(44) ; four-layer bandage (one study; 5%) (36) ; use of stocking (five studies; 23%) (18,(25)(26)(27)(28)(29)(30)34,41,44) ; intermittent pneumatic (two studies; 9%) (38)(39) latex free tubular bandage (one study; 5%) (37) . In 11 studies (50%) (18,28,(30)(31)(36)(37)(38)(39)(41)(42)(43) , some of these therapies were compared. The Unna boot was studied in 13 (60%) articles, of which 11 were c...…”

“…In articles analyzed in this review, the authors showed the use of two-layer bandage in the United Kingdom (40)(41) , the use of two-layer and multilayer bandage, and the Unna boot in the United States (34,36,37) , and two and four-layer bandage in Canada (36) . In New Zealand, attention was drawn to a study in which nurses applied compression therapies, and there were technical failures of the professionals.…”