Compression Therapy Resources

Despite advances in wound care, treatment of lower limb ulceration remains suboptimal, with poor outcomes often attributed to inadequate diagnosis, failure to follow evidence-based practice, and variations in care delivery. These shortcomings result in delayed healing, reduced quality of life (QoL), and a significant economic burden on healthcare systems. Compression therapy is the recommended treatment for venous ulcers and ulcers with mixed aetiology, however there are some individuals who may not respond to compression alone or who are unsuitable due to arterial status. Recent advances in adjunctive therapies, such as the geko^® device, offer promising results for these patients. This muscle pump activation (MPA) device activates the calf and foot muscle pumps,
increasing venous, arterial and microvascular blood flow. This article examines the impact of leg ulceration on healthcare services and patient outcomes, while exploring the potential of the geko^® device to improve healing rates and reduce associated costs.

Suboptimal management of leg ulcers is a growing burden on NHS nursing and financial resources (Guest et al, 2015; 2017; 2020). Compression therapy plays a crucial role in leg ulcer management by improving outcomes and reducing the burden of disease, however it is not routinely applied in practice and knowledge and confidence between bandage types and application styles often varies greatly (Guest et al, 2017; Hopkins, 2023). This article focuses on the importance of compression therapy in the management of leg ulceration and how to select the appropriate compression therapy based on the patient’s presenting symptoms. It identifies possible barriers to application and offers potential strategies and suggestions to support the use of compression options in the community.

The vast majority of wound care is undertaken by community nurses (Dhoonmoon, 2023), with £941 million attributed to venous leg ulcer care and a further £836 million spent on unspecified leg ulcer management (Guest et al, 2017). If signs and symptoms can be 
recognised and a diagnosis made, a plan of care can be drawn up and treatment implemented quickly and efficiently to reduce costs escalating further. More important though, the patient’s condition will improve quickly and deterioration in quality of life can be avoided. Nursing staff are currently encouraging patients to take a more active role in their own care, guiding them in how to look after their own long-term conditions, which can promote long lasting healing and independence.

This case series evaluation assessed the efficacy of WoundExpress™ (Huntleigh Healthcare), a novel IPC device, which applies compression to the thigh of the afflicted leg for the management of hard-to-heal leg ulcers. Eleven wound treatment centres or wound care specialists undertook WoundExpress evaluations. Eligible and willing patients (n=61), with a ‘hard-to heal’ leg ulcer used the WoundExpress device for two hours a day, in addition to continuing to receive their standard wound care for a 16-week period. Fifty-three participants completed the evaluations. Thirty-three percent (n=19) of all ulcers healed within the 16-week study period; the mean time to healing was 10 weeks. A further 60% of ulcers (n=35) progressed towards healing within the 16-week period, with a mean surface area reduction of 56% (23cm2). The evaluation concluded that thigh-administered IPC is an effective adjunctive treatment, that aids healing and reduces pain, for patients with hard to heal leg ulcers.

Increasing pressures experienced within community nursing are having detrimental effects on the care and treatment provided to patients. Among these is the management of venous leg ulcers, where a culture of passivity has possibly developed, resulting in significant delays in measuring patients’ ankle brachial pressure index (ABPI) and reduction in the use of full, therapeutic compression therapy. As pressures increase, so does the financial burden on the NHS and associated psychosocial impact often experienced by patients living with lower limb ulcers. Urgent reform of leg ulcer services is required to better manage these conditions and improve the quality of care received by patients. This article provides evidence from examples of successful service transformation, and puts forward recommendations for future practice.

It is estimated that 1.5% of the adult population in the UK is currently living with a leg ulcer (Guest et al, 2015). There is substantial evidence to suggest that venous leg ulcers are being poorly managed with delays in assessment, poor primary dressing choice and suboptimal levels of compression contributing to the delay in wound healing (Gray et al, 2018). The bulk of leg ulcer care takes place within primary care (Guest, 2015). Despite there being considerable evidence to support the use of compression therapy and undertaking accurate leg ulcer assessment, this does not appear to always happen in practice. This paper looks at how one clinic improved healing outcomes and patient quality of life through holistic assessment, patient education, supported self-care and introducing compression wraps into the treatment regimen.

Chronic oedema is a major clinical problem worldwide (Moffatt et al, 2019a). The condition has many important secondary consequences for health, activity and participation (Moffatt et al, 2017). Its prevalence also has a significant association with the presence of a wound (Moffatt et al, 2019b). There are many challenges to managing patients in this group, which can lead to ineffective and inappropriate care and have a significant impact on patient quality of life (Green and Meskell, 2016). This article discusses some of these challenges and the impact which they may have on patients and healthcare professionals caring for them.

We owe a great deal to the founder of modern nursing, Florence Nightingale, and as nurses we should always strive to further her work and that of other eminent practitioners. However, over the last few decades, approaches to nursing have moved away from the nurse doing 100% of the patient’s care, to patients being involved in their own treatment, and gaining increased independence and quality of life. By forging ahead in the development of modern techniques to improve patient care and working strategies of the nursing profession, we see improvements in terms of workload, staffing and budgets. This article looks back at the public’s perception of nurses, and how nursing roles have changed over time. It also considers wound care, a key component of the district nurse’s role, looking at how much progress has been made in the manufacture and use of compression therapy: from using multilayer bandaging to accurate, measurable and instantly adjustable compression wrap systems. By harnessing new therapies and techniques, healthcare professionals can both positively impact the lives of patients and improve their own working days.

Managing chronic oedema has a significant impact on NHS resources, especially in the primary care setting. As services continue to focus on care closer to home, and the population continues to age, this is only going to create more challenges for primary care teams in terms of resources, managing complex conditions and supporting older people in their own homes. Primary healthcare professionals come across older adults with chronic oedema more frequently than other healthcare professionals, and often have no formal training in the management of the complexities of the condition. Adapting to meet the growing needs of this patient group will require a change to current thinking and practice. This article discusses the management of chronic oedema and how using current evidence relating to inelastic compression devices can aid practitioners to be more efficient and effective in meeting these challenges, i.e. managing patients with chronic oedema and compression therapy, and provides case studies to support the use of these devices in primary care.