- Good evidence for healing ulcer (C6) and preventing recurrence (C5)
- Need to exclude PVD (arterial disease) - ideally ABPI
- Classification
- NB: TEDS (Thrombo-embolism Deterrent Stockings) = 10mmHg
- Class 1: 14 - 17mmHg at ankle
- Not very effective, maybe use in pregnancy
- Class 2: 18 - 24mmHg
- Commonly used, especially post-procedural
- Class 3: 25 - 35mmHg
- Often difficult to put on or remove
- Class 4: 35 - 50mmHg
- For Lymphedema & Elephantiasis
- Procedure
- 4-layer compression bandaging (exclude arterial disease first; ABI > 0.8)
- Base of toes to below knee
- 4 layer compression bandaging; redressed once per week
- 1st tubular cotton bandage
- 2nd orthopaedic wool
- 3rd & 4th short stretch Bandages applied in opposite directions
- Considerations
- May need to replace on first day as leg size rapidly shrinks (can return up to 900ml to circulation)
- Non-adherent dressing deepest (? Zinc impregnated cotton stocking) with emollient (aqueous) cream
- Hydrocolloid dressing used initially whilst moist – maybe dress twice a week whilst doing this
- Target ankle pressure = 40mmHg (knee 20mmHg)
- Compression ↑ ulcer healing rates
- Healing in 70% by 12/52 & in 80% by 24/52
- Once healed go back to Class 2 stockings