What are venous ulcers?
Chronic skin and subcutaneous lesions usually found on the lower extremity in the gaiter region.
What are risk factors of venous ulcers?
- Obesity
- Diabetes
- Sedentary lifestyle
- Family history
- Gestational diabetes
- Vascular disease
- Smoking
- Hypertension
- Hyperlipidemia
- Chronic kidney disease
What issues are associated with venous ulcers?
- Valvular reflux
- Obstruction
- Failure of the calf-muscle pump
What are associated causes of ulcers
- Accumulation of fibrin in tissue
- Accumulation of white blood cells in soft tissues, increased inflammation = increased breakdown of skin.
- Entrapment of growth factors and RBC: dark brown patches (hemosiderin)
What is the gold treatment for venous leg ulcers?
Compression therapy
What do prescription in compression therapy indicate?
They stipulate an amount of pressure to be applied, based on diagnosis, comorbid factors, and the patient’s willingness & ability to accept and adhere to treatment.
What are the indications of compressive therapy?
- Venous hypertension
- Edema
- Exudative Venous Ulcers
What are contraindications for compressive therapy?
- Arterial disease (ABPI < 0.5 - 0.8)
What are variables affecting compression?
- Tension
- Number of layers
- Leg circumference
- Bandage width
What are properties of compressive devices?
- Stiffness
- Elasticity / Stretch
- Re-usability (Adhesive/non-adhesive)
-Number of layers
In compressive devices, what does “stiffness” indicate?
- Ability of a textile to resist deformation under stress.
- Defined as the pressure increase produced by muscle contraction per centimeter of increase in leg circumference.
- Influences the amount of tension that can be exerted by the device.
In compressive devices, what does “elasticity/stretch” indicate?
- The textile’s ability to return to its original size after the pressure has been reduced.
- Determines the deviced / textile’s effect on the pressure at standing in resting position as well as working pressure generated during walk, when muscle contraction and dynamic changes in leg circumference occur.
- Short-stretch VS long-stretch
In compressive devices, what does “re-usability” indicate?
- Disposable products are used early in treatment when significant edema or an ulcer is present.
- Reusable compression products can be removed, cleaned, and then reused; primarily used for “maintenance compression” once the edema has resolved and the ulcer is significantly healed.
- Reusable products are non-adhesive wraps or garments.
In compressive devices, what does “Number of Layers” indicate?
MULTILAYER
- 2 or more layers
- Disposable
- Elastic - provide sustained compression
- Absorb exudate, making them preferred choice for active venous ulcers
SINGLE LAYER / STOCKINGS / VELCRO WRAPS
- Ideal for lower-pressure compression applications (preventing recurrence)
