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Compression therapies for venous disease and ulceration

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This second article of a two-part series on venous disease and ulceration will specifically outline treatment modalities to aid healing and help prevent active ulceration.

As advised previously, these treatments are only to be utilised in practice when a comprehensive holistic assessment has been performed coupled with a Doppler assessment that indicates no significant arterial disease or contraindications to compression therapy. If there is any doubt in the clinician's mind over the outcome of these assessments, specialist tissue viability or vascular support should be sought in line with local guidelines.

There is plenty of evidence to support compression therapies being beneficial in treating active venous ulceration and preventing venous ulcer occurrence.1

A major review of trials has indicated that compression is better than no compression and that patients are likely to heal quicker when receiving compression therapy.2

Compression bandaging

There is a consensus that multilayer compression bandaging is the appropriate treatment for active ulceration.3,4 The decisions surrounding the bandaging system applied will be influenced by the ankle brachial pressure index (ABPI) measurement and the holistic assessment at the outset.

For instance, if the ABPI is above 0.8,clearly compression bandaging is indicated, but if the ABPI falls below this value it is important that patients are assessed by the tissue viability team, who

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