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Venous ulcer management by specialised four-layer compression dressings

Venous Ulcer

When the vein valves or the calf muscle in the leg do not function properly, blood cannot flow adequately and accumulates in the lower leg. The vein walls extend, and the valves no longer seal firmly. This puts more pressure on the leg veins, starting to cause the legs to swell.

Swollen, congested tissue in the legs does not receive enough oxygen and nutrients. Waste materials are not disposed of and accumulate in the tissue. This results in an open sore known as a venous ulcer surrounding your foot or lower leg.

Signs and Symptoms

Fluid and blood cells seep out of the skin and tissues when blood accumulates in the veins of the lower leg. This can result in an itchy, thin skin and skin changes known as stasis dermatitis. This is a symptom of venous insufficiency. Visit Manipal Hospitals for endovascular surgery in Yeshwanthpur, Bangalore.

Early symptoms include,

  • Inflammation, stiffness, and cramps in the legs

  • Skin that is dark red, purple, or brown and has hardened (this is a sign that blood is accumulating)

  • Itching and tingling sensations

The following are common signs and symptoms of venous ulcers,

  • Shallow sore with a deep red base that is often coated with yellow tissue

  • Borders with irregular shapes

  • The skin around you may be glossy, tight, warm or heated, and discoloured.

  • Leg pain

  • If the wound becomes chronic, it may emit a foul odour, and fluid may drip from it.

Procedure

Four-layer compression dressings are the best compression therapy in the treatment of venous leg ulcers. The flexible layers of the four-layer technique are placed with pressure from the bottom of the toes. Failure to impart tension, and hence comparable pressure, over the foot can cause oedema rapidly accumulate over the dorsal side of the foot.

Orthopaedic wool Layer 1 

Orthopaedic wool creates a layer of cushioning that prevents pressure points like the ankle and foot. Dressings slippage and pressure can cause Achilles tendon injury. Thus this spot is adequately covered.

Crepe bandage Layer 2

This is the least useful layer since it only increases permeability and glosses out the orthopaedic layer before applying the two outer elastic bandages.

Elastic extensible bandage Layer 3

This is the first of two elastic dressings placed on the outside. It is a very stretchy bandage that offers sub-bandage pressure. If more pressure is needed on the calf, the following methods can be used,

  • Increasing gauze length, but be careful not to apply too much pressure.

  • Increased overlapping

  • Adding more layers of bandage.

 Elastic cohesive bandage Layer 4

This layer provides more compression and is not excessively extended. Wrapping is spread over the top section of the gastrocnemius muscle to avoid slippage. Because of the chance of latex allergy, the cohesive layer is not applied directly to the skin.

Prevention

Examine your feet and legs every day, especially the tops and bottoms, ankles, and heels, to check if you are at risk for venous ulcers. Check your skin for fissures and changes in colour. Book an appointment with us to know more about the preventive steps.

Lifestyle changes can help avoid venous ulcers. The following necessary precautions can improve blood flow and aid in healing.

  • Stop smoking immediately. It is harmful to not only your blood vessels but your whole body.

  • Maintain a healthy blood sugar level if you have diabetes. This will aid in your recovery if you are diagnosed with venous ulcers.

  • Exercise regularly to stay fit. Staying active leads to blood flow.

  • Eat healthy foods and get plenty of rest.

  • If you are overweight, you should try to lose excess weight.

  • Maintain healthy blood pressure and cholesterol level.

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