Overview
Reviewed by Dr. Keith Harding
Clinicians may choose to wrap a diabetic foot ulcer, or venous leg ulcer in a two-layer compression bandage. Two-layer compression bandages consist of a layer of zinc impregnated gauze and a self-adhesive elastic roll. Because compression may decrease arterial blood flow in the lower extremities, clinicians do not recommend two-layer compression therapy for patients suffering from arterial insufficiency or arterial disease.
Detailed Description
Before applying the two-layer compression bandages, the clinician will thoroughly cleanse the wound and apply the appropriate topical dressing.
The clinician applies the bandages in the following proscribed manner. He positions the foot at a right angle. If the foot is extended with the toe pointed when the clinician applies the bandages, it may cause pressure areas to develop in the ankle. First, the clinician applies the zinc-impregnated gauze in the pattern of a spiral, starting at the base of the toes and moving towards the heel. The clinician stabilizes the wrap by using a spiral pattern of wrapping the gauze around the foot. The gauze should be wrapped without tension, and each turn should overlap by fifty percent, meaning that half of the gauze doubles on top of the previous turn’s wrap, while half moves onto the adjacent part of the foot. Next the clinician wraps the back of the heel, circling back to the base of the foot in the pattern of a figure eight. It is important to completely cover the heel, because any area of the heel left unexposed may swell. Once the clinician has covered the heel, he should continue to wrap the ankle and leg in a spiral fashion, overlapping each turn by 50%, or half the width of the wrap. Wrapping the leg evenly is really important because it provides uniform pressure support. However, it is important to remember to avoid applying tension.
The second layer of two-layer wrap is a self-adhesive elastic roll. Clinicians should apply the self-adhesive wrap in a similar fashion as the first layer, starting the spiral wrap at the base of the toes, utilizing a figure eight around the heel and then continuing the spiral pattern up the leg. Like the first layer, each turn should overlap by 50%. When wrapping the self-adhesive layer around the heel, pull six to eight inches of the bandage away from the roll and stretch it to 50%. Continue this with each layer up the leg.
If you experience increased pain, numbness or tingling, or if the dressing slips down significantly, call your health care provider.
Finally, take precautions to prevent your compression bandage from getting wet. If your health care professional approves of exercise, you should take walks, as walking can help dissipate swelling. If not, do foot exercises by flexing and pointing the foot. Try to avoid sitting for prolonged periods of time. Also, elevate your legs above your heart, particularly if the bandage feels like it is getting tighter.
Last updated: 19-May-04
