Journal of Community Nursing

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JCN Supplement 2016 23
LEG ULCER RECURRENCE
regimen. After the demonstration,
Amy decided that she was happy to
try juxtafit.
The juxtafit is a stronger device
than the juxtalite (see‘Science’box
for a full explanation of the different
juxta products), and is designed
for patients with chronic oedema
and lymphoedema. Amy felt that
the device was aesthetically more
acceptable than bandages
or hosiery.
Amy’s latest incidence of recurrent
ulceration healed using the juxtalite
system and she switched to the
juxtalite permanently to prevent
further recurrence of venous leg ulcers.
She was extremely impressed with
the outcome of the treatment and at
the time of writing remains self-caring
and healed.
EVIDENCE
Elvin (2015) showed that converting
patients to juxta products resulted in
improved quality of life scores when
judged against the compression
techniques used previously. Elvin
(2015) stated that additional benefits to
using juxta products include:
 Improved clinical and personal
outcomes for patients
 Improved quality of life scores using
a visual analogue scale (VAS), with
1 equalling‘very unhappy’, and
5 indicating‘very happy’. Of the
patients surveyed, 74% scored the
maximum score of 5, indicating that
they were very happy with
the product
 Instant return to conventional
footwear for patients
 Improved ability to self-care.
CONCLUSION
When a venous leg ulcer has healed
it is important to maintain a level of
compression to prevent recurrence.
This is a challenge for the patient and
nurse and in some cases leads to
long-term bandaging as the only
possible solution.
However, the recent introduction
of wraparound devices that include a
system for measuring the compression
applied has resulted in an effective
alternative for preventing recurrence.
The benefits of these systems
is clearly demonstrated in the case
studies above, where adoption of these
new devices led to improved quality
of life for patients who had become
disillusioned with conventional
compression therapy. Cost and time
savings were also achieved (National
Institute for Health and Care Excellence
[NICE], 2015; Wicks, 2015).
Listening to patients and trying to
understand the issues they face with
compression garments are important
factors to consider to ensure that
patient concordance is achieved. In the
case studies featured here, the juxta
devices offered solutions that were
safe and easy for patients to use and
thereby encouraged concordance with
compression therapy. JCN
To cite this article: Mahoney K (2016) A
simple and effective solution to preventing
recurrent venous leg ulcers. J Community Nurs
30(4): 24–8
REFERENCES
Anderson I (2012) Encouraging compliance
and concordance in leg ulcer patients .
Wounds UK 8(1 Suppl): S6–8
Elvin S (2015) Implementing change using
innovation to improve the patient
experience. Poster presentation at Queen's
Nursing Institute annual conference,
London
Damstra RJ, Partsch H (2013) Prospective,
randomised, control trial comparing
the effectiveness of adjustable
compressionVelcro wraps versus inelastic
multicomponent compression bandages in
the initial treatment of leg lymphoedema. J
Vasc SurgVenous Lymphat Disord 1(1): 13–9
Gray D (2013) Achieving compression therapy
concordance in the new NHS: A challenge
for clinicians. J Comm Nurs 27(4): 107–10
Harding K and the Expert Working
Group (2015) Simplifying venous
leg ulcer management. Consensus
document. Available online: www.
woundsinternational.com (accessed 12
July, 2016)
Lawrence G (2014) JuxtaCURES: an innovative
method of providing compression for leg
ulcer management. Wounds UK 10(1):
64–70
Mosti G, Cavezzi A, Partsch H, Urson S,
Campana F (2015) AdjustableVelcro
compression devices are more effective
than inelastic bandages in reducing venous
edema in the initial treatment phase: a
randomized controlled trial. Eur JVasc
Endovasc Surg 50(3): 368–74
Moffatt C, Kommala D, Dourdin N, et al (2009)
Venous leg ulcers: patient concordance
with compression therapy and its impact
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Int Wound J 6(5): 386–93
NICE (2015) The juxtacures adjustable
compression system for treating venous leg
ulcers. Available online:
advice/mib25 (accessed 8 July, 2016)
Nelson EA, Bell-Syer SEM (2014)Compression
for preventing recurrence of venous ulcers.
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SIGN (2010) Management of ChronicVenous Leg
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Smith M (2016) Appropriate compression is
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Wicks G (2015) An alternative to compression
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Nurs 29(4): 40–6
KEY POINTS
 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, particularly over the
long term.
 This article looks at a
new adjustableVelcro
compression device, juxtalite (part
of the juxta™ range; medi UK),
which is designed to be simple
to apply.
 The system has a built-in pressure
system that allows the nurse to
accurately monitor the level of
compression being applied to the
limb, ensuring a therapeutic level
of compression is maintained.
 This article demonstrates a series
of case studies that show how
the system aids patient
concordance with treatment over
a period of time.