Question

Mr.R has a suspected venous ulcer. Before starting compression therapy nurse should ensure

Answer 1

Compression therapy is the mainstay of treatment of venous leg ulcers (VLU). Good wound care and compression therapy will heal majority of small venous ulcers of short duration.[1] Goals of compression therapy are ulcer healing, reduction of pain and edema, and prevention of recurrence.[2] Compression is used for VLU and narrows veins and restores valve competence and reduces ambulatory venous pressure, thus reducing venous reflux (VR). It also helps decrease inflammatory cytokines, accelerates capillary flow, and lowers capillary fluid leakage thereby alleviating limb edema. It also softens lipodermatosclerosis, improves lymphatic flow and function, and enhances fibrinolysis.

Answer 2

Answer:

Mr.R has a suspected venous ulcer. Before starting compression therapy nurse should ensure following precautions :

• All bandages used in compression must be applied on top of padding (subcompression wadding bandage) to prevent friction and pressure damage over bony prominences by spreading pressure across a greater area.
• Bandages should generally be applied toe to knee at 50% stretch and with 50% overlap but specific manufacturer's instructions should be followed for each bandage.
• Interface pressure peaks on the leg during walking exceeding 50-60 mm Hg reduce VR and increase venous pumping function.
• Compression therapy is a highly effective treatment for VLU. Care should be taken while administering this therapeutic modality in case of mixed-arteriovenous ulcers.
• The minimum tolerable compression pressure tailored to the patient's requirement should be ensured so as to maximize compliance.

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