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Compression Therapy in Ulcer Care

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Pearls and Pitfalls in Skin Ulcer Management

Abstract

Compression therapy (CT) is the mainstay of venous leg ulcer (VLU) care caused by venous disease resulting in ambulatory venous hypertension. CT is able to counteract the venous hemodynamic impairment and prevent/treat leg edema having a negative impact on ulcer healing. A strong compression is necessary to counterbalance the impaired venous hemodynamics, and a light compression is able to treat/prevent edema. Inelastic devices (inelastic bandages and adjustable compression wraps), able to overcome the intravenous pressure and to restore a valve mechanism, are preferred in large and long-standing VLU. Inelastic bandages are difficult to apply and need a proper education of the healthcare personnel. Adjustable compression wraps are easier to apply, even by the patients themselves allowing self-management and significant cost-saving. In case of small and recent onset venous ulcers, elastic kits, made up of two superimposed stockings and exerting a moderate pressure, can be used. The first layer maintains the dressing in place, stays overnight, and is removed for ulcer cleansing and dressing change. The second layer will be applied during the day to achieve the correct pressure. Compression can be applied also in mixed ulcers provided that arterial disease is moderate and compression pressure is not >40 mmHg.

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Authors and Affiliations

  1. Angiology Department, Clinica MD Barbantini, Lucca, Italy

    Giovanni Mosti

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  1. Giovanni Mosti
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Editors and Affiliations

  1. Unit of Plastic and Reconstructive Surgery, Department of Precision and Regenerative Medicine and Jonic Area, University of Bari, Bari, Italy

    Michele Maruccia

  2. Plastic Surgery Unit, University of Trieste, Cattinara Hospital, Trieste, Italy

    Giovanni Papa

  3. Difficult Wound Healing Unit, Policlinico di Monza, Vercelli, Italy, Italy

    Elia Ricci

  4. Plastic and Reconstructive Surgery, University of Bari Aldo Moro, Bari, Italy

    Giuseppe Giudice

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Mosti, G. (2023). Compression Therapy in Ulcer Care. In: Maruccia, M., Papa, G., Ricci, E., Giudice, G. (eds) Pearls and Pitfalls in Skin Ulcer Management. Springer, Cham. https://doi.org/10.1007/978-3-031-45453-0_12

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