Compression Resources

With more than 90,000 catheter users in the UK, evidence suggests that catheter blockage is a common problem impacting on patient’s health outcomes. Approximately 50% of people with long-term catheters will experience catheter blockages that have been caused by encrustation or biofilm formation (Gibney, 2016).

This case report explores the community management of a patient with a medical history of heart failure (HF) and oedema. Gold standard guidelines recommend targeting clinical congestion and oedema with increased loop diuretics alongside multilayer compression bandages for effective limb decongestion, reduction of swelling and limb shape restoration. Without early identification and intervention, oedema can worsen, leading to skin changes such as lymphorrhoea (wet or leaky legs), and having a detrimental physical, functional, and psycho-emotional impact on patients. Yet, HF and oedema continue to be mismanaged because healthcare workers have reservations about the use of compression therapy and concerns about overloading the circulatory system in patients with HF. This case report demonstrates appropriate treatment and management of oedema in patients with HF within a community district team setting, highlighting best guidance on diuretics, compression therapy, exercise, and skin care.

Many ostomates experience leaks at some points in their lives. However, some experience frequent leaks, which lead to physical complications such as sore skin, bleeding and pain, as well as having a negative impact on their emotional wellbeing and quality of life. Worrying about leaks can result in reduced sleep, social isolation and low mood — all of which can be emotionally exhausting and stressful. Effective stoma management is essential to prevent leaks and maintain peristomal skin integrity, such as the use of convex base plates. There are five characteristics of convexity which when applied correctly can reduce leaks and improve skin health, namely: depth, compressibility, flexibility, tension location and slope. These characteristics work together to achieve the desired outcome. However, tension location can be used in a different method to flatten large creases and dips. This helps to promote skin integrity and improve patient comfort and confidence in managing their stoma, as this article describes.

This article, the first in a two-part series, introduces and discusses the importance of movement and gait on the lower extremity in relation to chronic venous insufficiency (CVI) and chronic oedema (CO). It outlines and highlights the importance of the venous and lymphatic systems and their influence on how fluid is moved from the periphery into the trunk. The article introduces and explores the role of important anatomical systems like the veno-muscular pumps within the lower extremity, and how underlying  musculoskeletal (MSK) issues that affect movement and walking can influence
the onset, chronicity, and severity of CVI and CO. It also touches on how fluid is moved from the lower extremity into the trunk. Finally, the importance of compression and its benefits are explained through key scientific principles and the vital role that it plays in
fluid movement from the periphery into the trunk. The second part of the series will focus on how movement, orthotics and footwear can complement compression and their role in reducing peripheral oedema, improving gait and managing pain in the foot and ankle.

Do you make decisions on which compression system to use? Are you involved in selecting and measuring for compression?

Selecting the correct type and size of compression can be time-consuming and confusing. The L&R Compression Selector app aims to support clinicians by simplifying the process. It can quickly and effectively suggest options from the L&R compression range that would be suitable for patient’s needs. Whether that is ReadyWrap® adjustable wrap system, Activa®, ActiLymph®, Adore compression hosiery, or the L&R leg ulcer hosiery kit, the app can support you.

Lower limb haematomas caused by trauma are debilitating wounds for the elderly who are most at risk. Prompt action needs to be taken to stop the bleeding and reduce the extent of tissue damage and skin loss. Literature on the management of lower leg haematoma is sparse compared to the management of skin tears, and there may be debate regarding surgical versus conservative approach. Many patients are not suitable for surgery due to underlying comorbidities, frailty and anaesthetic risk. Conservative management should support early evacuation of the haematoma and application of compression bandaging, avoiding lengthy hospital stays and enabling patients to be managed in the community setting.

Lower limb ulceration is a common, debilitating and costly condition that accounts for over one third of chronic wounds in the UK. The most common underlying causes of leg and foot ulceration are venous insufficiency, arterial insufficiency, lymphoedema and diabetic neuropathy. More than half of leg ulcers do not have a recorded diagnosis and are unlikely to receive appropriate care. Poor care can cost up to ten times as much as appropriate care. The Legs Matter campaign aims to change this situation through a public health campaign supported by a website: http://legsmatter.org. The website provides clearly written, easily accessible information for patients, the public and generalist healthcare professionals along with signposts to reputable sources of information. In this way, the campaign aims to raise awareness that leg and foot conditions can be improved with the right care. 

The second in this four-part series exploring leg ulcer management and understanding compression therapy examines the role of assessment as the basis for optimal clinical practice. The authors explore how the findings of thorough assessment can influence treatment choice. Adopting an holistic, person-centred approach to assessment, which includes taking an ankle brachial pressure index (ABPI) reading and involves the patient in decision-making will help nurses to make effective clinical decisions and plan care in partnership with patients. This article discusses a three-stage assessment and clinical decision-making process, which involves looking at the whole person, assessing the leg and the wound. The next article in the series will examine compression hosiery and adjustable wraps for the management of the lower limb.