Use of a Novel Two-layer Bandage in the Treatment of Chronic Venous Hypertension

Abstract

Since the development of Unna boot therapies, there has been development in newer technologies for venous compression syndromes and chronic venous hypertension. Chronic lower extremity venous insufficiency results in venous stasis, edema and hypercongestion of the lower extremities. Given the breadth of potential uses, the goal of this study was to retrospectively compile and analyze the clinical application and effectiveness of a 2-layer zinc-impregnated foam Unna boot bandage (Andover Healthcare, Salisbury, MA) in patients with lower extremity swelling with or without wounds treated by a single physician and monitored for 12 weeks post-application in the outpatient setting. In patients with complex comorbidities, the use of this new foam-impregnated multi-layer compression Unna boot shows efficacy in reduction of edema and wound size within 12 weeks. This newer therapy shows extensive promise in the ability to keep patients adherent to treatment regimens with higher rates of success.

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.…”

“…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 conducted in Brazil (18)(19)25,26,(28)(29)(30)(31)(32)(33) , and the others in the USA (34) , Poland (38) and United Kingdom (40) ; in five of these studies (23%), the Unna boot was compared to another therapy (28,(30)(31)34,44) , and in eight (36%) (18)(19)(25)(26)(27)29,(32)(33)35) only the boot was studied.…”

“…When the Unna boot was compared to other therapies, it demonstrated a shorter healing time than the single and two-layer elastic bandage (30,41) . Among the results and benefits of using compression therapy in venous ulcers, eight articles (36%) indicated the effectiveness of the Unna boot in control of edema, reduction of wound area and wound healing, and for improving patients' quality of life (18)(19)25,27,29,(32)(33)(34) . In two studies (9%), the low rate of indication of this therapy by professionals was criticized (26,40) .…”