A Discourse on the Bandages to be used for Leg Ulcers

Ever since compression was first used, bandage technology has developed and slowly made progress. Bandages are henceforth designed for specific performances like offering effective sub-bandage pressures.

There is a lot of care that needs to be taken for the application of compression bandages as an even pressure gradient is most essential between the knee and the ankle along the length of the bandage. For achieving that, it is vital that you apply even amount of tension all throughout the length so that it is equally distributed.

In most of the cases, the correct tension is mentioned in the product description offered by the manufacturer. Apart from that, it is also important that the required overlap is obtained with each turn. This is especially true when the spiral technique is being used. Usually it is recommended to get fifty percent overlap. For guiding the practitioner’s hand there is a red line running through the middle of some bandages.

Nowadays leg ulcers are being treated with a range of pressures that vary to suit various circumstances. The various compression bandaging systems like short stretch bandages, long-stretch bandages that offer minimal stretch as well as tubular and cotton crepe bandages.

With all the compression bandages, the padding using orthopaedic wool is utilised for redistributing  pressure from bony prominences. This actually assists in providing even pressure distribution under the compression bandages where even graduated pressure can militate the shape of the leg.

Here a range of bandages is provided on the basis of the pressure.  Just read on to know.

  • Multi-layered Inelastic Compression – The bandages in this group offer less than 50% stretch.
  • Multi-layered Elastic Compression – The bandages in this group provide more than 50% stretch.
  • Sustained Compression – The bandages in this category are capable of maintaining sub-bandage pressures for minimum one week.
  • Reduced Compression – The bandages in this group contain systems delivering sub-bandage pressure of 15-25 mmHg for patients with Ankle Brachial Pressure Index (ABPI) between .8-.5 or narrow ankles.
  • Intermittent Pneumatic Compression – The bandages in this category deliver high compression for short periods of time.
  • Compression Stockings –These are used in care of varicose veins or primarily used for prevention of recurrence.

Inelastic systems tend to give less amount of sub-bandage pressure at the time when the patient rests but offers rigid   support to the calf muscles when the patient is exercising. This leads to the reduction of the oedema very fast requiring the re-application of the bandage very quickly.

In the multi-layer systems, the cumulative pressure that is exerted is the sum of pressures exerted by individual layers. It has been seen through research that the four-layer bandaging offers better healing than the others.

In order to make sure that the bandages have been applied correctly, the proficient practitioners must undertake a holistic assessment of this patient prior to the application of any bandage.  For venous leg ulcers, compression therapy involving velfour bandage remains the primary treatment and practitioners must seek for the best practices to ensure that their patients have positive outcomes.