The fourth and final article in this four-part series about understanding compression therapy explores the options available to clinicians and patients when the need for compression bandaging therapy has been established through holistic assessment. This paper presents an overview of both inelastic and elastic bandage systems. In addition, the indications for appropriate use of each of these systems and their limitations are discussed. The cost of compression bandaging to the health service budget in terms of sustainability, equipment and clinician time is also explored. Gait is a fundamental area of leg ulcer care that needs assessment as part of lower limb management. Discussion regarding the implications of compression bandaging therapy itself, as well as the presence of leg ulcers and pain on gait are provided. Finally, a review of fundamental skin care principles to protect the skin is offered.
When trying to prevent the recurrence of leg ulcers, many community nurses find it hard to get patients to concord with compression devices and techniques, particulary over the long term.
This article looks at a new adjustable Velcro compression device, juxtalite (part of the juxta® range; medi UK), which is designed to be simple to apply. It has built-in pressure system (BPSTM) that allows the nurse to accurately monitor the level of compression being applied to the limb, ensuring a therapeutic level of compression is maintained. Here, the author relates her own expreience of using the juxta system (in particular the juxalite version) through a series of case studies that show how the system aids patient concordance with treatment over an extended period of time.
Community nurses often work in isolation and are not always able to attend best practice updates in venous leg ulcer treatment. As a result, they do not always possess the up-to-date knowledge and skills to manage these patients. This project reached out to local ways of delivering compression therapy; in this case an adjustable Velcro compression device, juxtacures (juxtacures®; medi UK). The juxtacures range is designed to be simple to apply with a built-in pressure system that allows the nurse to accurately monitor the level of compression being applied to the limb. This ensures a therapeutic level of compression is maintained. The authors felt and skill level in compression bandaging. The aims of the project were to reduce the amount and duration of community nursing visits to patients with venous leg ulcers while ensuring that safe, visits to patients with lower limb problems, with some patients successfully discharged to self-manage their lower limbs.
Lynfa Edwards discusses compression bandaging in the treatment of venous leg ulcers
Andrea Stigant gives an overview of the role of the lymphoedema practitioner and using a case study approach provides information on lymphoedema and its treatment.
Andrea Stigant MSCP, ENBN34 is a Clinical Lymphoedema Specialist, Eden Valley Hospice.
Article accepted for publication: September 2006
Jeanette Muldoon discusses the challenges of managing patients with lymphoedema and chronic oedema.
Jeanette Muldoon is a PhD student at King's College, London and Head of Clinical Services, Activa Healthcare.
Article accepted for publication: March 2011
