Submitted by Barry Creighton DPM (not verified) on February 06, 2012, Nancy Slone-Rivera, MS, ANP-C, CWON, CFCN, and Stephanie C. Wu, DPM, MSc. It is important to mention that current stocking classifications are not standardized. 6. European Wound Management Association (EWMA) position document. She is an Associate Professor for the Center for Stem Cell and Regenerative Medicine at the School of Graduate and Postdoctoral Studies at the Rosalind Franklin University of Medicine and Science. 2008;15(1):27-30. 31. Since the link oxide does not cake or dry out, this type of bandage and stay on longer than other methods. Chronic venous insufficiency and venous ulceration. Callam MJ, Ruckley CV, Dale JJ, Harper DR. Venous Disease is associated with an impaired range of ankle movement. Christopoulos D, Nicolaides AN, Cook A, Irvine A, Galloway JM, Wilkinson A. Pathogenesis of venous ulceration in relation to the calf muscle pump function. The smaller the limb and the narrower the bandage, the higher the pressure. By Jeffrey E. McAlister, DPM, FACFAS, and Eric So, DPM, AACFAS |. As the authors appropriately state, this compression level can fall of rather abruptly with time. 25mmHg on ankle circumference (18-25 cm), Apply figure of 8 around ankle with a high and low turn. I would like to clarify a point with regard to the definitions herein of inelastic versus short stretch, which I believe, as stated, allow for confusion, even historically, predating 2006. J Gen Intern Med. This bandage works as a barrier to keep patients from scratching ulcerated wounds and prevents infection. Cochrane Database Syst Rev. When using compression stockings, patients should receive instruction that it is best to shower in the evening and then don their socks first thing in the morning before edema has a chance to accumulate in the limb. Compression therapy in patients with peripheral arterial occlusive disease: A prospective clinical study with the 3M Coban 2 Layer Lite Compression System for ABPI >/= 0.5. 12. 2. Multiple factors have been implicated as contributing to poor therapy adherence.45 One of the inconveniences with compression bandages is the necessity to keep the dressing dry. 1997. Clinicians may employ short stretch bandages to decrease edema. 2. Dr. Wu is the Director of the aforementioned CLEAR at the Scholl College of Podiatric Medicine. However, they are unable to sustain consistent compression for prolonged periods of time.23 The inelastic characteristics of these types of bandages do not allow for contouring of the bandage to the leg circumference once the edema has decreased. When it comes to long-term ulcers, clinicians can teach caregivers how to apply short stretch reusable bandages.27 The bandages can be washed per manufacturer recommendations and hung to dry. Arterial insufficiency and ulceration: diagnosis and treatment options. These all work together to facilitate a proper healing environment. Roaldsen KS, Elfving B, Stanghelle JK, Mattsson E. Effect of multilayer high-compression bandaging on ankle range of motion and oxygen cost of walking. Peripheral arterial disease in people with diabetes. Retrieved from http://www.worldwidewounds.com/2001/march/Vowden/Doppler-assessment-and… on December 1, 2011. 1995;22(5):519-23. Ostomy Wound Manage. Types of compression bandages. Alguire PC, Mathes BM. Compression bandaging. 5. Inflammatory cytokine levels in chronic venous insufficiency ulcer tissue before and after compression therapy. World Wide Wounds. Compression bandages: There are two main types of bandages: inelastic or short-stretch bandages, and long-stretch elastic bandages. Some medical supply stores have a compression specialist on staff. Ely JW, Osheroff JA, Chambliss ML, Ebell MH. The second layer will be a conforming dressing for increased comfort in hard to bandage areas. MEP Ltd., London, 2003:2-4. Does the provider know how hard he is he is pulling? Khachemoune A KC. 2001;6(9):S17-S21. Ms. Rivera is an instructor at the Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science in Chicago. Management of leg ulcers. Avoid excessive padding which reduces pressure, Density and conformability of different products varies. Compression wrapping is primarily used to help alleviate swelling and offer support for a sprain, strain, or other injury. Unable to apply high levels of compression. 24. To qualify, it is often necessary to produce documentation of venous ulcers that are unresponsive to standard treatment for at least six months. Several companies make high compression elastic bandages that have rectangular or square markings along the bandage to ensure a constant tension during application. Smith LJ, Harrison MB, Graham ID, Lamb M. Community leg ulcer bandaging study: lessons learned in a pilot, randomized controlled trial. 2nd ed. The Unna boot should be replaced every week or so until the ulcer has healed. The type of bandage used depends on the severity of the swelling and how much pressure needs to be applied. However, this service seems to be less frequently available. 2009;6(5):386-93. Br J Surg. MEP Ltd., London, 2003:2-4. Lindsay J MJ, Hampton S. Short Stretch compression bandage and the foot pump: their relationship to restricted mobility. In such cases, the clinician may consider an initial treatment with an Unna boot or multilayer lower compression bandage to manage the heavy drainage, and transition to the inelastic or short stretch bandage after successful exudate management. Patients who have a negative first experience with compression may be less willing to continue the treatment.35. Marston W, Vowden K. Compression therapy: a guide to safe practice. © 2020 HMP. I don't believe inelastic products are historically considered to be products with 30 to 70% stretch. 2003;25(6):556-61. Once venous ulcers heal, one needs to consider the use of maintenance therapy to prevent recurrence. However, there is a lack of agreement over their classification and confusion over …